Theme | Theme description |
---|---|
Major theme 1: Why a program is considered ineffective | |
Lack of program fit | Program was ill-suited to the populations served by the state health department. |
No measured benefits | Local data demonstrated no or little positive outcomes, despite the program being evidence-based in other populations or settings. |
Unknown effectiveness | Lack of evaluation data or the right type of evaluation data led to practitioner views that a program was ineffective. |
Staffing constraints | Lack of sufficient staff or dedicated time to support successful program implementation or scale-up. |
Major theme 2: Why ineffective programs are continued | |
Inertia and sunk costs | Complex, grant-funded public health programs may be difficult to modify after implementation begins, and losing the money and time spent on initial implementation may decrease practitioners’ incentives to modify an ineffective program. |
Information gaps | Agencies may not have adequate information to decide whether to continue a program, e.g., if evaluation was not built into the initial plan. |
Desire to act | Public health staff may feel good that they are doing something to address a community concern, regardless of the effectiveness of the action. |
Agency capacity | Agencies may lack the money, time, and personnel needed to identify, decide on, and implement changes to an existing program. |
Program champions | The presence of someone in the SHD or community who is vocal about wanting a program to continue may challenge efforts to modify or discontinue an ineffective program. |
Partnership maintenance | Ineffective programs may be continued to support strong relationships with community partners who are invested in a program. |