Module 1 Draft Asthma Program Evaluation Guide

Appendix F
Individual Evaluation Plan Outline

{State Program Name}

Individual Evaluation Plan
{Name of evaluation candidate}

Prepared by:
{Names}
{Affiliation}

{Date}

Page F-1

Individual Evaluation Plan Outline

Learning and Growing through Evaluation

Module 1 Draft

1. INTRODUCTION
This section provides information about the purpose of the evaluation, and what stakeholders
areor need to beinvolved in the evaluation.
Evaluation Purpose

What does this evaluation strive to achieve?

What is the purpose of this evaluation?

How will findings from the evaluation be used?

Stakeholders

Who are the stakeholders for this evaluation?

This
This section
section of
of the
the plan
plan
corresponds
corresponds with
with Chapter
Chapter 3,
3,
Step
Step 1,
1, of
of the
the State
State Asthma
Asthma
Program
Program Evaluation
Evaluation Guide
Guide

What role did they play in developing this

individual evaluation plan?

How do you plan to engage these stakeholders

when implementing the individual evaluation plan (e.g., participate in collecting data,
help to interpret findings)?
Table F.1. Stakeholder Assessment and Engagement Plan
Stakeholder
Name

Stakeholder
Category
{Primary,
secondary, tertiary}

Appendix F

Page F-2

Interest or
Perspective

Role in the
Evaluation

How and
When to
Engage

Module 1 Draft Asthma Program Evaluation Guide

2. DESCRIPTION

OF

WHAT

IS

BEING EVALUATED

This section provides detailed information about what you are

evaluating. In this section describe the need, context, target
population, and stage of development of what is being evaluated.
You will also provide information on inputs, activities, outputs,
and outcomes and will develop a logic model (graphical
depiction) of what you are evaluating.

This
This section
section of
of the
the plan
plan
corresponds
corresponds with
with Chapter
Chapter 3,
3,
Step
Step 22 of
of the
the State
State Asthma
Asthma
Program
Program Evaluation
Evaluation Guide
Guide

Need

What is the need for what you are evaluating?

Context

What context/environment exists for what is being evaluated?

(i.e., what environmental factors may affect the performance of what is being evaluated)
Target Population

Who is the target population? (if applicable)

Stage of Development

How long has what is being evaluated been in place?

Is it in the planning or implementation stage?

Resources/Inputs

What resources are available to support what is being evaluated (e.g., staff,
money, space, time, partnerships, technology, etc.)?
Activities

What specific activities are undertaken (or planned) to achieve the outcomes?

Outputs

What products (e.g., materials, units of services delivered) are produced by your
staff as a result of the activities performed?
Outcomes

Page F-3

Individual Evaluation Plan Outline

Learning and Growing through Evaluation

Module 1 Draft

What are the programs intended outcomes (intended outcomes are short-term,
intermediate, or long-term)?

What do you ultimately want to change as a result of your activities (long-term

outcomes)?

What occurs between your activities and the point at which you see these ultimate
outcomes (short-term and intermediate outcomes)?
Table F.2. Program Description Template
Resources/Inputs

Activities
Initial

Outputs

Subsequent

Outcomes
ShortTerm/Intermediate

LongTerm

Logic Model

Provide a logic model for what is being evaluated.

3. EVALUATION DESIGN
This section provides information on how you will design your
evaluation. Provide information on evaluation questions,
stakeholder information needs emerging from the evaluation, and
the evaluation design.

This
This section
section of
of the
the plan
plan
corresponds
with
Chapter
corresponds with Chapter 3,
3,
Step
Step 33 of
of the
the State
State Asthma
Asthma
Program
Program Evaluation
Evaluation Guide
Guide

Evaluation Questions

What specific questions do you intend to answer through this evaluation?

Stakeholder Needs

Who will use the evaluation findings?

What do they need to learn from the evaluation?

How will the findings be used?

What do intended users view as credible information?

Evaluation Design

What is the design for this evaluation? (e.g., experimental, pre-post with
comparison group, time-series, case study, post-test only)

Appendix F

Why was this design selected?

Page F-4

Module 1 Draft Asthma Program Evaluation Guide

4. DATA COLLECTION
This section provides information on how you will collect/compile
data for your evaluation. Provide information on methods by
which you will collect/compile data, and how those methods are
related to the evaluation questions you identified.

This
This section
section of
of the
the plan
plan
corresponds
corresponds with
with Chapter
Chapter 3,
3,
Step
Step 44 of
of the
the State
State Asthma
Asthma
Program
Program Evaluation
Evaluation Guide
Guide

Data Collection Methods

Will new data be collected/compiled to answer the evaluation questions or will

secondary data be used?

What methods will be used to collect or acquire the data?

Will a sample be used? If so, how will the sample be selected?

How will data collection instruments be identified and tested?

How will the quality and utility of existing data be determined?

From whom or from what will data be collected (source of data)?

How will the data be protected?

Data Collection Method Evaluation Question Link

How does each data collection method relate to the evaluation questions
proposed?
Table F.3: Evaluation Questions and Associated Data Collection Methods
Evaluation Question

Data Collection Method

1.
2.

Page F-5

Individual Evaluation Plan Outline

Source of Data

Learning and Growing through Evaluation

5.

DATA ANALYSIS

Module 1 Draft

AND INTERPRETATION

In this section provide information on what indicators and

standards you will use to judge success, how you will analyze
your evaluation findings, and how you will interpret and justify
your conclusions.

This
This section
section of
of the
the plan
plan
corresponds
with
Chapter
corresponds with Chapter 3,
3,
Steps
Steps 44 and
and 55 of
of the
the State
State
Asthma
Asthma Program
Program Evaluation
Evaluation
Guide
Guide

Indicators and Standards

What are some measurable or observable elements that can tell you about the
performance of what is being evaluated?

What constitutes success? (i.e., by what standards will you compare your
evaluation findings?)
Table F.4. Indicators and Success
Evaluation Question

Criteria or Indicator

Standards
(What Constitutes
Success?)

1.
2.

Analysis

What method will you use to analyze your data (e.g., descriptive statistics,
inferential statistics, content analysis)?

Provide example table shells, if applicable.

Interpretation

Who will you involve in drawing, interpreting, and justifying conclusions?

What are your plans to involve them in this process?

Appendix F

Page F-6

Module 1 Draft Asthma Program Evaluation Guide

6.

COMMUNICATION

AND

REPORTING

This section provides information about how information from

the individual evaluation plan process and results will be used
and shared.

This
This section
section of
of the
the plan
plan
corresponds
corresponds with
with Chapter
Chapter 3,
3,
Step
Step 66 of
of the
the CDC
CDC State
State
Asthma
Asthma Program
Program Evaluation
Evaluation
Guide
Guide

Use

What actions will be taken to promote evaluation use?

How will evaluation findings be used?

Who is responsible for implementing evaluation recommendations?

Communication

Which evaluation stakeholders will you communicate with and why (e.g., update
on status of evaluation, invite to meetings, share interim or final findings)?

What methods (e.g., in-person meetings, emails, written reports, presentations)

will you use to communicate with evaluation stakeholders?

Why are these methods appropriate for the specific evaluation stakeholder
audience of interest?

7. EVALUATION MANAGEMENT
This section provides information about how the individual
This
This section
section of
of the
the plan
plan
evaluation will be managed and implemented and who will
corresponds
with
Chapter
33 of
corresponds
with
Chapter
of
participate in what capacity. It will also provide a timeline for
the
the CDC
CDC State
State Asthma
Asthma
conducting activities related to this evaluation. You may find
Program
Program Evaluation
Evaluation Guide
Guide
that some of the tables suggested here fit better in other sections
(section
(section on
on Pulling
Pulling ItIt All
All
Together)
of the plan. Regardless of how you structure your plan, it is
Together)
important that you carefully think about each of these
implementation steps and who is responsible for doing what by when.

Develop several tables that summarize the major activities included in

implementing the evaluation, the persons involved in this implementation, and associated
timelines.

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Individual Evaluation Plan Outline

Learning and Growing through Evaluation

Module 1 Draft

Evaluation Team

Who will implement this evaluation?

Table F.5. Roles and Responsibilities of the Evaluation Team Members
Individual

Title or Role

Responsibilities

Data Collection Management

What data will be collected?

What activities are needed to carry out the data collection successfully? When
should each of these activities be completed?

Who is responsible for conducting each activity?

Table F.6. Data Collection Plan

Evaluation
Data Collection
Questions
Method
1.

Activities
Needed

Person(s)
Responsible

Due Date

2.

Data Analysis Management

What data will be analyzed, how, and when?

Who is responsible for conducting the analyses?

Table F.7. Data Analysis Plan

Analysis to Be Performed

Appendix F

Page F-8

Data to Be
Analyzed

Person(s)
Responsible

Due Date

Module 1 Draft Asthma Program Evaluation Guide

Communicating and Reporting Management

What are the target audiences for reporting the progress made on the evaluation
and/or evaluation findings?

What is the purpose of the communications with this audience?

What is the most appropriate type of communication method to use with this
audience, for this purpose?

When will the communication take place?

Table F.8. Communication and Reporting Plan

Audience 1: {insert name of audience}
Applicable?

Purpose of Communication

Yes/No

Possible
Formats

Timing/Dates

Notes

Include in decision making

about evaluation
design/activities
Inform about specific upcoming
evaluation activities
Keep informed about progress
of the evaluation
Present initial/interim findings
Present complete/final findings
Document the evaluation and
its findings

Adapted from Russ-Eft and Preskill, 2001, pp. 354357.

Timeline

When will planning and administrative tasks occur?

When will any pilot testing occur?

When will formal data collection and analysis tasks occur?

When will information dissemination tasks occur?

Upon mapping all of the above on a single timeline, are there any foreseeable
bottlenecks or sequencing issues?
Evaluation Budget

What is the cost for this evaluation?

Where will the monetary resources come from to support the evaluation?
Are any in-kind, volunteer, or partner resources being contributed?

Page F-9

Individual Evaluation Plan Outline

Learning and Growing through Evaluation

Module 1 Draft

NOTES

Appendix F

Page F-10