Since the sodium reduction program does not reach everyone, the validity of your approach may be in question. If you narrow the intent of the evaluation to those who participated, then you will have a more valid view of the impact of the program. I think this is what makes your choice of "overall satisfaction" a reliable indicator of the success of the program.

How can this approach be narrowed to those ones who participated.

Please read the evaluation below.

The WISEWOMAN program is a significant public health initiative in Pueblo, Colorado that provides essential services to a vulnerable population of women. The program aims to prevent chronic diseases by educating and empowering women to adopt healthier lifestyles and effectively manage their risk factors for cardiovascular disease. Chronic diseases are a significant public health concern in the United States, with cardiovascular disease being women's leading cause of death. The WISEWOMAN program is a vital resource for women who may not have regular access to healthcare due to financial or other barriers. A practical method for assessing the efficacy of public health programs, such as the WISEWOMAN program, is the outcome evaluation design. This design measures changes in health outcomes caused by the program's interventions. By evaluating the program's impact on health outcomes, the evaluation can determine whether its goals and objectives are met and identify areas for improvement. This type of evaluation is crucial for programs such as WISEWOMAN, which aims to prevent chronic diseases by promoting healthy behaviors and managing risk factors. The WISEWOMAN program is a crucial public health initiative that addresses a major health concern in the United States. This program evaluation can assess the program's effectiveness and ensure that it meets the needs of its target population by utilizing an outcome evaluation design (CDC, 2021). The evaluation can offer valuable insights into the most effective strategies for preventing chronic diseases and promoting cardiovascular health among vulnerable women.

Measurement Strategy

A comprehensive measurement strategy is indispensable to assess a program's efficacy. A well-designed strategy should provide accurate and trustworthy data on program outcomes, such as changes in health behavior and outcomes. In this case, the measurement strategy for the evaluation combines self-reported and clinical data to offer a more comprehensive picture of the program's implications on cardiovascular health (CDC, 2012). The specified evaluation indicators are critical for measuring cardiovascular health outcomes.The indicators that can be considered for evaluating the WISEWOMAN Public Health Program in Pueblo, Colorado, include the following:changes in behavior, including physical activity levels, healthy eating habits, BMI, and smoking cessation rates. Reduction of cardiovascular disease risk factors, include high blood pressure levels, high cholesterol levels, and obesity rates among program participants. Other indicators to be considered are number of women who receive screenings and referrals, impact on reducing health disparities by providing access to care for underserved populations, and community stakeholders' perspective on the program's implementation and effectiveness. These indicators are relevant to the program's objectives and provide insight into the program's impact and effectiveness.

These indicators have been utilized in previous program evaluations for comparison purposes and are regarded as valid and reliable measures of cardiovascular health outcomes. For instance, the indicators of changes in behavior, reduced disparities in heart disease and stroke, reduce blood pressure, and cholesterol levels have been used in multiples program evaluations to improve cardiovascular disease and risk factors. "The Centers for Disease Control and Prevention (CDC) and the Division for Heart Disease and Stroke Prevention (DHDSP) have developed guides with these indicators to assist in the evaluation of heart disease and stroke prevention activities and as a tool to implement in program evaluations" (CDC, 2023, para. 4). In a study, middle age women and men were asked to participate in a recent evaluation where the indicators the blood pressure, cholesterol, and changes in behavior were used to monitor progress in this targeted group (Dunn et al., 1997). In six months of intervention, there was improvement in cardiovascular disease.

Several measurement strategies can be used to collect data on the previous indicators, such as surveys and existing administrative data. For example, surveys collect self-reported data, which can provide information on health behaviors such as physical activity levels and tobacco use. Surveys are efficient for gathering participant data and can provide valuable insights into their perceptions of the program. Self-reported data may be biased, and participants may not always provide accurate or truthful responses. Another measurement strategy to be used is existing administrative data such as health records review. The use of these measurement strategies can help to ensure the accuracy and reliability of the data collected.

To address this limitation, clinical data will be collected via medical record reviews and physical examinations (CDC, 2021). Administrative data from electronic health records and other program records could be used to collect data on the number of women who receive screenings and referrals to specialists for appropriate care. Moreover,medical record reviews can yield information on health outcomes such as blood pressure, cholesterol levels, and vital cardiovascular health indicators (NCSD, 2023).

Data can be collected through various means to avoid bias and have control over quality data, such as physical assessments, paper-based surveys, telephone interviews, in person-interviews, and focus groups. For instance,physical assessments, such as blood pressure measurements and BMI evaluations, are performed by trained program personnel, ensuring the accuracy and reliability of the data collected. Collecting data at multiple points is necessary to assess the program's long-term impact (Program Performance and Evaluation Office, 2018).

Furthermore, surveys, and interviews could be used to collect data on physical activity levels, healthy eating habits, and smoking cessation rates among program participants. Focus groups can provide valuable insights into participants' experiences with the program, including their likes and dislikes, suggestions for improvement, and perceived benefits from the participants and the community stakeholders. Moreover, focus groups could be used to collect data on the program's impact on reducing health disparities among underserved populations.

Follow-up surveys will be conducted at the end of the program and 12 months after program completion to assess changes in health behaviors and outcomes over time. This approach provides insight into the sustainability of behavior change and helps to determine whether the program's impact is long-lasting. By collecting data at multiple time points and employing reliable and valid measures of cardiovascular health results, the evaluation can provide valuable insights into the program's effectiveness and inform future program design and implementation.

Validity

Validity is a crucial aspect of program evaluation that ensures accurate, reliable, and representative results. Internal validity refers to the precision and accuracy of the evaluation's measures. External validity, in contrast, refers to the extent to which an evaluation's results can be generalized to other populations and settings (Hamilton & Finley, 2019). In this context, internal validity is ensured by evaluating cardiovascular health outcomes with reliable and valid measures. These measures have been utilized in prior program evaluations, which lends credibility to them. In addition, the self-reported data collected through surveys will be pre-tested to ensure that they are comprehensible, reliable, and accurate. Using standardized procedures for medical record reviews and physical assessments conducted by program staff will also guarantee the accuracy and dependability of the collected data.

External validity is ensured by recruiting a representative sample of women from Pueblo, Colorado, who are served by the WISEWOMAN program. Collecting demographic information, such as age, race, and income, guarantees that the sample is representative of the program population. However, it is essential to note that the evaluation's external validity may be restricted to other low-income, underinsured, or uninsured 40-64-year-old women in similar settings (CDC, 2022). Consequently, it may not be possible to generalize the results of this evaluation to other populations or settings that lack comparable characteristics (Hamilton & Finley, 2019). Validity is essential in program evaluation to produce accurate, reliable, and representative results. The evaluation's measures must be dependable and valid, and the data collected must be exact. External validity must also be considered to generalize the findings to other populations and settings.

Reliability

Reliability is an essential factor in program evaluation that ensures the consistency and stability of the measures used to assess the program's effectiveness. Reliable measures aid in minimizing measurement errors, which can compromise the precision of evaluation results. Therefore, the WISEWOMAN program evaluation strategy will include measures to ensure the evaluation's reliability (CDC, 2022). In order to ensure internal consistency, the evaluation's survey questions will be designed to measure the same constructs across all survey waves. This will ensure that the evaluation questions measure the same thing consistently, which is essential for minimizing measurement error (Hamilton & Finley, 2019). In addition, the survey questions will be piloted with a small sample of program participants to ensure that they are clear and that respondents interpret them as intended.

Physical evaluations, such as blood pressure and body mass index (BMI) measurements, will be performed by trained program personnel using standardized protocols to ensure stability. This indicates that the same methods and procedures will be used throughout the evaluation to minimize measurement error (CDC, 2012). In addition, the same staff members will conduct baseline and follow-up physical assessments to ensure consistency and stability in measurements. To ensure that the evaluation results accurately reflect the program's efficacy, the WISEWOMAN program evaluation relies heavily on the measures' validity (CDC, 2021). Consequently, the evaluation strategy will include measures to ensure internal stability and consistency in the physical assessments, thereby minimizing measurement errors and enhancing the accuracy of the evaluation results.