Overview
For this milestone, due in Module Four, you will determine the most important evaluation questions and the evaluation design to be used in your final program evaluation plan. The evaluation focus will depend on the program stage of development and what stakeholders want to learn about the program. The evaluation questions will be described in terms of the evaluation standards (utility, feasibility, propriety, and accuracy). The evaluation design will be described as either implementation, outcome, or mixed methods. The purpose of this milestone is to establish the priorities and methods that will be used to evaluate the program.
Prompt
First, provide an introduction to your program evaluation plan that includes a summary of the selected program, the public health issue addressed by the program, the program stage of development, and community stakeholders identified for the evaluation.
Next, specify the evaluation design to be used from the three types introduced in the course: implementation/process, outcome, or mixed method. Based on the evaluation type chosen, specify the 3–5 evaluation questions that will be the focus for the evaluation. Examine the CDC standards of utility, feasibility, propriety, and accuracy to determine if this set of questions meets the needs of this evaluation. Analyze how the program evaluation will provide answers to questions that will ensure use in the community.
Address the following critical elements:
Introduction:Describe the program and community selected for the evaluation and the public health issue addressed by the program.Describe the stage of development of the program in the selected community.Identify community stakeholders for this program evaluation.Evaluating the Selected Program: Describe what type of evaluation you will use to evaluate the program.The evaluation types covered in the course include implementation/process, outcome, or mixed method. Specify which one of these you are using for this evaluation.Indicate why the selected evaluation type is appropriate given the program stage of development.Evaluation Questions: Specify 3–5 evaluation questions that are appropriate to the program stage of development and address stakeholder questions about the program.List the evaluation questions that will be used for your project. Review the CDC evaluation guide for types of questions that are often posed for process evaluations and outcome evaluations.Indicate which program elements will be examined by each question.Summarize how the questions address each of the CDC standards including utility, feasibility, propriety, and accuracy.Ensure Use of the Findings:How will the evaluation type you have chosen ensure use of the findings and provide lessons learned that will continue to improve programs targeting this issue? 1
Milestone 1: Sodium Reduction in Communities Program
Devonte Hayes
Southern New Hampshire University
July 9, 2023
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Milestone 1: Sodium Reduction in Communities Program
Introduction
Sodium Reduction in Communities Program (SRCP) is the Public Health Program I
chose to focus on for my final project. This initiative falls under the Division for the Prevention
of Heart Disease and Stroke. The SRCP was developed to assist individuals in reducing their
sodium consumption in specific communities. The Sodium Reduction in Communities Program
collaborates with various culinary service and food delivery organizations in the designated
communities. These organizations include schools, food banks, company cafeterias, and
hospitals. (CDC, 2023). The Sodium Reduction in Communities Program has partnered with
eight communities and food industry allies to reduce sodium consumption through communitylevel interventions that can be sustained over time (CDC, 2023).
Program Overview
The program was chosen due to the significant effects of sodium on the human body,
which include the development of cardiac disease and stroke due to excessive sodium
consumption. In addition, the program’s emphasis on reducing sodium consumption in our local
environment significantly influenced my decision. Sodium is a mineral that occurs naturally in
various food sources and is also intentionally added to processed food products.
SRCP’s Logic Model and Program Components
It appears that the Sodium Reduction in Communities Program intends to achieve its
objective of reducing sodium intake in the eight communities primarily by encouraging people to
choose food with a significantly lower sodium content by making healthier options more
accessible. In addition, they are concentrating on educating the residents of these communities
about which products are healthier and lower in sodium (Long, 2018). According to the Centre
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for Disease Control, prepackaged foods are processed foods, so “more than 70 percent of the
sodium Americans consume comes from processed and restaurant foods, not the salt shaker”
(CDC, 2023). These communities must receive an education so they can choose better, healthier
foods to consume.
The SRCP logic model describes the relationships between its program components. It
requires partnerships, community engagement, and funding as inputs. Implementing sodium
reduction strategies, conducting educational campaigns, and promoting healthier food options are
among the activities. Increased accessibility to lower sodium diets and increased community
awareness are the results. Reduced sodium consumption, decreased heart disease and stroke
rates, and enhanced population health are the intended results.
The program’s success is contingent upon the participation of various community
stakeholders, such as culinary service providers, government agencies, healthcare professionals,
community organizations, and residents. These stakeholders play crucial roles in implementing
and evaluating the program’s initiatives, ensuring their pervasive adoption and long-lasting
impact.
Public Health Issue
The sodium reduction communities program (SRCP) aims to reduce high blood pressure,
heart attacks, and strokes caused by excess sodium consumption. According to the Centres for
Disease Control and Prevention, high blood pressure is responsible for around 500,000 deaths
yearly; lowering sodium intake could save thousands of lives yearly (CDC, 2023). By altering
public menus, planning and implementing service recommendations, and making salt-reduced
meals affordable and accessible in communities, the initiative implements strategies to prevent
excessive sodium consumption.
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In addition to minimizing salt consumption, educating the public about sodium sources,
the negative health effects of high sodium consumption, and the importance of avoiding and
controlling high blood pressure and other cardiac problems is critical. According to the National
Library of Medicine article, sodium reduction includes the following activities: Collaborating
with the food industry to reduce sodium in the food supply, providing technical and
programmatic assistance to the public health community; and working together with other
government agencies and stakeholders on sodium-related monitoring and evaluation of ongoing
sodium reduction (Jachimowicz-Rogowska & Winiarska-Mieczan, 2023 ).
The sodium reduction communities program is aimed at adults who eat too much sodium.
This group consists of both men and women and individuals of both white and African descent.
This publication’s subject matter focuses on the discipline of nutrition. Hypertension in the
United States is approximately 33 percent, or 78 million adults, according to data from 2007 to
2010 (Mugavero et al., 2013). Notably, African American adults have one of the highest
prevalence rates of hypertension globally, with approximately 44% affected. The incidence of
hypertension and stroke has significantly increased in the United States.
Program Evaluation
The program’s main objective is to reduce sodium consumption in the community
to improve public health outcomes. This initiative was inspired by the realization that excessive
sodium consumption is associated with an increased risk of developing cardiovascular disease,
hypertension, and stroke, all of which can result in premature death. Consequently, monitoring
the community’s health closely needs at the state, national, and local levels is essential. The goal
of the evaluation is to assess the effectiveness of the SRCP in reducing sodium consumption in
the targeted communities. It also aims to ascertain its effect on lowering the incidence of
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hypertension, heart attack, and stroke. In addition, the evaluation provides information regarding
the program’s reach, adoption, and longevity. This evaluation applies to the CDC, local health
departments, community stakeholders, and public health intervention researchers.
Theoretical Basis and Program Effectiveness
The SRCP applies the Health Belief Model, which focuses on the beliefs and perceptions
of individuals regarding health risks and behavior modification. This model emphasizes
perceived susceptibility, severity, benefits, obstacles, and self-efficacy. The program seeks to
motivate individuals to make healthier choices by addressing these factors. This model was used
to help understand why people utilized or did not utilize preventative services offered by public
health departments and was later modified to focus more on prevention, detection, and lifestyle
behaviors.
The health belief model posits that an individual’s perception of disease risk influences
their propensity to act. In this program, it refers to whether a person believes they consume too
much sodium or are at risk for stroke or heart disease. The subsequent construct is perceived
severity if the individual knows how excessive sodium consumption can negatively impact them.
The third factor is perceived benefits, or what the individual believes he or she will gain by
reducing sodium consumption (Robles, 2018). The fourth construct, perceived barriers, refers to
what the individual believes will prevent them from reducing their sodium intake. Will it be
prohibitively expensive to purchase foods with less sodium? The spur to action is the fifth
element. What will it take to alter the sodium consumption habits of the target population?
Lastly, do we have the self-efficacy construct, or does the individual feel confident they have the
necessary resources to implement the change?
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Health Disparities
Robles (2018) defines a health disparity as a specific health difference strongly correlated
with social or economic disadvantage. These disparities harm entire groups that already face
substantially greater obstacles to maintaining good health due to socioeconomic status or
income, ethnic background, age, sex or gender, etc. Socioeconomic factors, such as income and
education levels, can impact the availability and affordability of healthier dietary options.
Individuals may be unable to receive preventative care and health education if they do not have
proper access to healthcare facilities and services (Fulgoni et al., 2014). Cultural elements like
dietary habits and traditions may impact how salt reduction measures are adopted.
Social Determinants
Social determinants of health, including elements like education, environment, and work,
can substantially impact the program evaluation. The degree of education attained by a person
can affect their understanding of program objectives, capacity to make well-informed decisions
about sodium reduction, and level of health literacy (Fulgoni et al., 2014). Environmental factors,
particularly the availability and affordability of low-sodium food options within a particular
region, can substantially impact a person’s ability to adopt and uphold healthy eating habits.
Economic stability and job situations can also impact one’s ability to prioritize health-promoting
habits and gain access to resources.
Conclusion
The SRCP aims to address public health issues associated with excessive sodium
consumption, such as hypertension, myocardial infarction, and cerebrovascular accidents. The
program employs various strategies to mitigate excessive sodium ingestion, including modifying
public menus, developing and enforcing service guidelines, and promoting the availability and
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accessibility of foods with reduced sodium content in communities. In addition, it is crucial to
educate the public on the origins of sodium and the negative effects of excessive sodium
consumption on general health.
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References
California. Center for Disease Control. Retrieved May 15, 2022, from
CDC (2023, May 03). CDC Division for Heart Disease and Stroke Prevention (DHDSP) Home.
Retrieved from https://www.cdc.gov/dhdsp/index.htm
Fulgoni, V. L., Agarwal, S., Spence, L., & Samuel, P. (2014). Sodium intake in US ethnic
subgroups and potential impact of a new sodium reduction technology: NHANES Dietary
Modeling. Nutr. J., 13(1), 1–9. doi: 10.1186/1475-2891-13-120
https://www.cdc.gov/dhdsp/docs/SRCP_SS_SoCalifornia.pdf
Jachimowicz-Rogowska, K., & Winiarska-Mieczan, A. (2023). Initiatives to Reduce the Content
of Sodium in Food Products and Meals and Improve the Population’s Health. Nutrients,
15(10). doi: 10.3390/nu15102393
Long, C. R. (2018). Reducing the intake of sodium in community settings: evaluation of year one
activities in the Sodium Reduction in Communities Program, Arkansas, 2016–2017.
Preventing Chronic Disease, 15.
Mugavero, K., Losby, J. L., Gunn, J. P., Levings, J. L., & Lane, R. I. (2012). Reducing sodium
intake at the community level: the Sodium Reduction in Communities Program.
Preventing Chronic Disease, 9.
Robles, B. (2018, June). Reducing Sodium in Hospital Food Service Operations Across Southern
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