Evaluation of HIV/AIDS Treatment Programmes

Assessment No. 1

Josefina B. dela Cuesta

Cornell Institute of Business and Technology

DIPHAM 707 : Evaluative Models

24 Febraury 2017

Introduction

Research plays a vital role in our lives especially in the health care setting wherein it gives a lot of benefits and make the people life easier and faster. Research is described as a systematic process of collecting and understanding of information for the main purpose of growing the understanding of a definite phenomenon or event in which individual’s concerns most. Furthermore, research involves different distinctive characteristics like, it starts with a certain question or a problem, research has a specific goal or objectives, accepts assumptions, and lastly through research it divides major problem into a handier sub problems (Shuttleworth, 2014)

In every research, it is important to evaluate to see the effectiveness or efficacy of a certain project. Evaluation is a technique that on a very basic level reviews a program. It incorporates assembling and exploring information about a program’s activities, qualities, and results. Its inspiration is to make judgments about a program, to upgrade its suitability, or possibly to exhort programming decisions Moreover, it is extremely imperative to have an evaluation particularly in the medical services setting to guarantee the viability of the program and to recognize the zones that requirements change and help to adapt up to the objectives productively (Thompson, 2003).

Background of the study

HIV andAids are one of the most serious illnesses globally and unfortunately there is no cure yet for this kind of disease. Everyday globally there are approximately 2.2 million (6.5%) of the estimated 34 million people engage with HIV  in 2011 ages ranges from 10- 19 years old(Unicef New Zealand,2016). Furthermore, in 2015, 224 individuals were determined to have HIV in New Zealand, with 109 of those having been tainted in New Zealand. This is higher than 2014 when 217 were analyzed (New Zeland Aids Foundation, 2016).HIV stands for Human Immuno deficiency Virus while AIDS stands for Acquired Immuno Deficiency Syndrome. HIV  is a virus that make weakens the  immune system of the body and if left untreated considered as life threatening and it will be categorize as a serious stage of HIV infection. There is no cure for HIV, however with appropriate care what’s more, treatment, a great many people with HIV can maintain a strategic distance from getting AIDS and can remain solid for quite a while. Anti-HIV drugs must be taken each day. They can’t dispose of HIV yet, they can monitor it .Additionally, HIV can acquire through body fluids, close body contact, and blood as well as semen (Catie, 2010).

This paper will discuss and analyze five (5) evaluation researches about HIV/AIDS and to critically identify its significance, methodology contribution to the topic and the quality. Moreover, this paper also includes analyzing the four audit and evaluation process such as Impact evaluation, Economic, Process, and Outcome evaluation and approaches and investigate the current health programme.

Evaluation Researches

Evaluation of HIV Australia for the Australian Federation of Aids Organization

This evaluation utilizes qualitative methodology to lead an assessment of the way toward creating the magazine, and for an evaluation of the effect of the magazine, especially for its commitment towards HIV policy advancement. This research was conducted as a resource of advocacy and policy development of HIV in Australia. The result of this study was successfully published in the in the different sector in Australia as a source of advocacy of HIV with clear awareness of the different policy and insights about individual role. Additionally, this research gives an overview of the different key issues associated with HIV (Loughlin, 2014).

This significance of this study is to increase the awareness of the Australian population and to increase their awareness on HIV and to provide policies on HIV prevention. This study contributes through additional information and knowledge of the researcher and serves as guideline in formulating alternatives for HIV and Aids prevention.

Outcomes and Processes at a Camp Program for Youth with HIV/AIDS in United States

This research study evaluated the outcome and process at a Camp for Youth with HIV/AIDS with chronic illness in the United States. On this study they utilized qualitative method using employing observations, focus group, and interviews. The result of this study showed that through camping played a major developmental role especially for the youth, first outcome forming caring connection (awareness of commonalities, lack of isolation) secondly feeling reprieve and recreation recreation (fun activities, anticipation of and reflection on camp, and lastly growing knowledge, attitudes, and skills (conflict management, disclosure, skill learning and education, medication adherence) (Gillard, Witt, & Watts, 2011).

The significance of this study serve as a therapeutic intervention for youth with HIV/AIDS who are engaged with HIV/AIDS in the United States and it provides additional opportunities with the youth to connect with others and provide and nurturing relationship. This study contributes to the individuals especially in New Zealand who belong to the age of 10-19 years old to actively participate on this kind of activity to develop a fostering relationship ant to increase the awareness on HIV/Aids prevention.

Effective or Not? Case Study Evaluation of a HIV/AIDS Workplace Program Policy at a Swedish Owned Company in Botswana

This research study measure or evaluates the knowledge about HIV/AIDS, attitudes concerning HIV/AIDS and self-reported sexual behavior among employees and through that examine the effectiveness of the case company’s HIV/AIDS Workplace Program Policy in Botswana and used qualitative method in gathering data using  14 questionnaires,  six interviews and 5 field observations. The result of this study found that it exist a high level of knowledge about HIV/AIDS among the employees of the company, and there were no notable sign of hostile attitude towards HIV infected individuals and most of the respondent estimated their sexual behavior as a low risk when it comes to get a HIV infection(Bergström
&
Liljeqvist, 2010).

The significance of this study was to see to what extent a specific HIV/AIDS Workplace Program Policy at a Swedish owned company in Botswana has come to the employees’ attention .The relevant of this study is its serves as a guideline for the prevention of HIV/Aids especially for the sexually active individuals and learn their behavior towards getting of HIV/AIDS.

Economic Evaluation of Community-Based HIV Prevention Programs in Ontario: Evidence of Effectiveness in Reducing HIV Infections and Health Care Costs

This study evaluates the community based HIV prevention programs in Ontario Canada; that is effective in reducing the HIV infections and health care cost. It was showed that from the year 1987 to 2011, province-wide community-based programs helped to avert a total of 16,672 HIV infections, saving Ontario’s health care system approximately$6.5 billion Canadian dollars (range 4.8-7.5B). Moreover it also showed that these community-based HIV program were cost-saving: from 2005 to 2011, every dollar invested in these programs saved about $5 and they use quantitative data in gathering through approvals from the provincial and federal governments of Ontario Canada (Choi, Holtgrave, Bacon, Kennedy, Lush McGee, Tomlinson, Rourke, 2015).

The significance of this study is to understand the impact of investing in community-based HIV prevention programs in Ontario and recognizing the impact that these programs have had in reducing HIV infections and health care costs (Choi et al, 2015). Moreover, this research study is very relevant to the topic because it will serve as guidelines in reducing HIV/Aids especially in reducing the cost of HIV/AIDS cases.

Process evaluation of the teacher training for an AIDS prevention program in South Africa

This evaluation research process study the six (6) – day teacher program which forms part of a sexuality education project in South Africa. The result of this study indicate that teachers reported that there was increased in their confidence and comfort in teaching the sexuality curriculum.  Qualitative data was used in gathering data questionnaires were administered prior to the training, on completion of the training and at two follow-up time periods were analyzed as well as participant observation notes (Ahmed, Flisher , Mathews,Jansen, Mukoma, and Schaalma,2006).

The significance of this study is the need for HIV education to form part of teacher trainee program. Furthermore, ongoing support and engagement with teachers is needed to encourage alternative teaching practices. Additionally, it provide teachers with the essential knowledge and skills to effectively teach a 16-lesson Grade 8 (14 year olds) life skills curriculum consisting of participatory exercises on sexual reproductive health, human immunodeficiency virus (HIV), sexual decision making ,abstinence, consequences of sexual activity, safe sex practices, substance abuse and sexual violence. This study contributes to reduce the incidence of HIV/ AIDS especially for the youth and to gain more knowledge on prevention of HIV/Aids.

Audit and Evaluation Process

Outcome Evaluation of a Case Study of a HIV/AIDS Workplace Program Policy at a Swedish Owned Company in Botswana

Outcome evaluation defined as to measure the effectiveness of a program in creating a change (Linnell, 2014). This study evaluates to see in what extent a specific HIV/Aids workplace program policy in Botswana to the employees’s attention. The definite objective of this study was to measure the knowledge of the employee about HIV/AIDS, attitudes concerning HIV/AIDS and self-reported sexual behavior among employees and through that examine the effectiveness of the case company’s HIV/AIDS Workplace Program Policy. Furthermore, the researchers examine “how” and “why” the HIV/AIDS Workplace Program Policy is effective or not to the company. Moreover, the researcher used of qualitative data and it’s an evaluative single-case study with a holistic design with multiple sources of evidence; six interviews, 14 questionnaires and 5 field observations has been done on this study (Bergström
&
Liljeqvist, 2010).

The findings shows that there is no significant sign of hostile attitudes towards HIV infected individuals and most of the employees responds are estimated that their sexual behavior is at low risk when it comes to get a HIV infection. Evaluating this study will help to reduce the incidence of HIV/AIDs and to increase their awareness on prevention of HIV/AIDS of the employees of Botswana.

Economic Evaluation of Community-Based HIV Prevention Programs in Ontario: Evidence of Effectiveness in Reducing HIV Infections and Health Care Costs

Economic evaluation described as involves a placing value on the allocation of resources and determining the cost effectiveness or the cost benefit (Frick, 2007). This study evaluates the effectiveness of a community-based HIV prevention program in Ontario in reducing HIV infections and health care costs. Through this Community based HIV prevention program they were able to reduce the cost of the health care system in Ontario Canada, they were able to save $6.5 billion Canadian dollars (range 4.8-7.5B) and averted total of 16,672 HIV infections, (Choi et al, 2015).

This economic evaluation of this research study tackled the health care cost of HIV prevention program using a community based HIV program which has been found effectively in reducing their health care cost in Ontario Canada and they were able to abolish the HIV infections. This study is an important first step in understanding the impact of investing in community-based HIV prevention programs in Ontario and recognizing the impact that these programs have help in reducing HIV infections and health care costs.

Process evaluation of the teacher training for an AIDS prevention program in South Africa

Process evaluation described as to measures the effort and the direct outputs of a specific program or interventions of what and how much was accomplished , furthermore it can be done through continues onetime assessment (Hornik , 2007). This process evaluation studies the teacher training for and AIDS prevention program in South Africa which focuses on Grade school student specifically 14 years old. This study is a 6 day teacher training program that helps that teacher to provide necessary knowledge and skill sexual reproductive health, human immunodeficiency Virus (HIV), sexual decision making, abstinence and consequences of sexual.

This study makes use of qualitative data; questionnaires prior to training are made, on completion of the training and at a two follow-up time periods were analyzed as well as participant observation. This research study shows that teachers had an increased confidence in teaching sexuality as a part of their curriculum. This study is considered as a process evaluation because it’s a continues process on educating students by the teachers on sexuality and to be continually evaluated.

Impact Evaluation at a Camp Program for Youth With HIV/AIDS in United States

This research study analyses the impact of Camp Program for youth on HIV aids in the United States and it was found out that is very effective as a therapeutic intervention. This study makes use of qualitative data through direct observations, focus group, interviews and examined the outcomes that participate in the camp.

Impact Evaluation on this study shows that through Camp Program played an important role for the youth such as caring connection, feeling reprieve and recreation, and gaining knowledge, skills and necessary attitudes. The significant of this study serve as a therapeutic intervention for youth with HIV/AIDS who are engaged with HIV/AIDS in the United States and it provides additional opportunities with the youth to connect with others and provide and nurturing relationship (Gillard et.al 2011).The evaluation determines a decrease of HIV/AIDS cases through Camp Program that is design for the young age.

Evaluation Model

Figure 1: The Kirkpatrick’s Evaluation Model

Source The Kirkpatrick’s Evaluation Model retrieved from http://arcmit01.uncw.edu/jonesi/Evaluation.html

The Kirkpatrick’s Evaluation Model is relatively useful in determining the effectiveness of a specific intervention. The Kirkpatrick’s Model recognized four level of evaluation to measure organizational effectiveness and efficiency, which are the reaction, learning, behavior, and results. The first level, reaction evaluation focused on the feelings of the participants; furthermore this type of evaluation is intended to measure their satisfaction with the training they received. Furthermore, the second level the learning evaluation is the method of measuring the awareness or knowledge, attitudes and skills of participants and how effective the program has achieved the objectives (Jones, 2008).

Moreover, another stage of the Kirkpatrick’s Model is the behavior evaluation that focused on the observation of participants in the background of their job following training defining how much and what type of change has taken place. Lastly the results evaluation which asses the organizational change as a result of the intervention in specific area like improved productivity, reduced cost, better quality and improved morale. According to Jones(2008), in order to determine which type of evaluation model suits for a study or project the researcher must answer the question “why am I evaluating, answering this question will lead to a suitable and effective model for evaluating a certain program or a study.

Through this model evaluation it is very useful to in conducting a research study on HIV/Aids which in every stage focuses on specific task like for the first stage focusing on the feelings of the participants since HIV/Aids is a sensitive issue in our society, it is important to consider their feelings first before conducting a research study to have effective results. Secondly, the second stage which is the learning evaluation that focuses on the knowledge, skills and attitudes, considering these factors will lead to better intervention on HIV/AIDS. Lastly the behavior evaluation that focus on the background and observation of participants, in doing a research study it is very vital to consider their background to be more sensitive on their feeling and culture to have an effective data collection that would lead to better results and the last stage is the result evaluation that centers on the productivity cost and quality and morale that is necessary in conducting research especially costing which considered as  an important part because having proper budgeting it will  result to have better outcome of the study.

As to above mention evaluation model, this model can relate to the different type of evaluation, the first stage which is the reaction that can be a process evaluation which measures the inputs of a specific program on how it is being accomplished. The second stage is the learning that suits for an impact evaluation that focuses on the knowledge and skill if is being achieved or not. Furthermore, for the third stage the behavior model that relates to the outcome evaluation that focused on the action taken by the researcher if its effective or not, lastly the result stage that focuses on the costing and improved productivity that relays to economic evaluation that tackles on how research study is measured its cost effectiveness and the proper allocation of resources.

Conclusion

Evaluation is very vital to every research because it measures the effectiveness and efficiency of the program implemented so it is important to know the different evaluation that is applied to your chosen research to have a better outcome and results. Furthermore, having a good evaluation serves as guidelines in doing specific interventions especially in the health care setting, and with proper intervention it would lead to an effective better results and quality of care to the clients.

References

Ahmed, N., Flisher, A., Mathews, C., Jansen, S., Mukoma, W., & Schaalma, H. (2006). Process evaluation of the teacher training for an AIDS prevention programme. Health Education Research, 621-632.

Choi, S., Holtgrave, D., Bacon, J., Kennedy, R., Lush, J., McGee, F., et al. (2015). Economic Evaluation of Community-Based HIV PreventionPrograms in Ontario: Evidence of Effectiveness in Reducing HIVInfections and Health Care Costs. Retrieved February 2017, from Aids Behaviour: http://www.ohtn.on.ca/wp-content/uploads/2015/07/Economic-Evaluation-Community-Based-HIV-Programs-Ontario.pdf

Linnell, D. (2014, February 13). Process Evaluation vs. Outcome Evaluation. Retrieved February 2017, from Third Sector New England: http://tsne.org/blog/process-evaluation-vs-outcome-evaluation

‘Loughlin, B. (2014, December). Evaluation of HIV Australia For the Australian Federation of Aids Organization. Retrieved February 2017, from http://www.afao.org.au/library/topic/research/HIV-Australia-Evaluation-2014.pdf

Bergström, F., & Liljeqvist, N. (2010, January). Effective or Not? Case Study Evaluation of HIV/AIDS Workplace Program Policy at A Swedish Company in Botswana. Retrieved February 2017, from https://www.diva-portal.org/smash/get/diva2:292767/FULLTEXT01.pdf

Catie . (2010). What are HIV & AIDS? Retrieved February 2016, from Catie: http://www.catie.ca/pdf/Brochures/HIV-basics.pdf

Frick, K. (2007). Concepts in Economic Evaluation. Retrieved February 2017, from http://ocw.jhsph.edu/courses/ConceptsEconomicEvaluation/PDFs/Lecture1.pdf

Gillard, A., Witt, P., & Watts, C. (2011). Outcomes and Processes at a Camp for Youth With HIV/AIDS. Retrieved February 2017, from Sage Journals: http://journals.sagepub.com/doi/abs/10.1177/1049732311413907

Jones, I. (2008). Evaluation. Retrieved February 2017, from Master of Science Instructional Technology: http://arcmit01.uncw.edu/jonesi/Evaluation.html

Thompson, G. (2003). What is it? and Why do it? Retrieved February 16, 2016, from Thompson, G. (2003). Evaluation: What is it http://meera.snre.umich.edu/evaluation-what-it-and-why-do-it