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Program Evaluation: Using National TB Indicators Project (NTIP)

Judy Gibson, MSN, RNProgram Evaluation Team (PET)

Field Services and Evaluation Branch (FSEB)Division of Tuberculosis Elimination (DTBE)

NCHHSTP/CCID/CDC

TB/Refugee Nurse Training Commonwealth of Virginia 2009

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Presentation Outline

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Describe NTIP and the National TB Program Objectives

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Understand importance of NTIP in TB control and program evaluation (PE)

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Describe CDC/DTBE Program Evaluation (PE) approach

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NTIP and National TB Program Objectives

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What is NTIP?

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A program monitoring system•

Indicator reports-

inform progress toward national objectives

-

focus program evaluation efforts-

provide performance targets as benchmark for

assessment

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http://www.cdc.gov/tb/publications/factsheets/stat istics/NTIP.htm

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Data Sources for NTIP

NTIP

Cases(RVCT*)

USCensus

Contacts(ARPE*)

Immigrants/Refugees(EDN*) TB GIMS*

*RVCT= Report of Verified Cases of Tuberculosis*ARPE= Aggregate Reports of Program Evaluation*EDN= Electronic Disease Notification System *GIMS= Genotyping Information Management System

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Selecting Potential NTIP Objectives

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Stakeholders submitted wide range of objectives

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Focus only on those with existing data•

Result: 28 potential objectives

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Stakeholders ranked and grouped objectives into 15 categories

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National:

Established by the National Objective Workgroup

Based on the “current”

performance of a high

performing state

Method used uniformly across all objectives

Suggestions on methods accepted for future

Program:•

Set their own targets for objectives based on the capacity and resource availability

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Targets to be agreed on with DTBE consultants

Establishing NTIP Targets

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National TB Program Objectives 2015

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NationalObjective

State Performance

Graph

State Data

Method

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Example: TB Treatment Completion

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7%

89%

0%

0%

1%

3%

Completed Within 12 Months

Completed After 12 Months

Moved

Lost to Follow-Up

Refused

Unknown/Other

Treatment Completion for Eligible Patients, by Treatment Outcomes,

State X, 2003

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Example: Know HIV Status

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Example: Know HIV Status (cont)

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Example: Contact Investigation

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Example: Drug Susceptibility Results

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Integrating NTIP into Program Practice

MonitorProgressToward

Objective

Met Target

Did not Meet Target

Develop Evaluation Plan to Understand Barriers/Challenges

Provide Evaluation Updates

Complete Evaluation

Refine/Develop Program Activities Based on Findings

(CoAg application)

Implement Improvements

Best Practices

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NTIP will

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Reinforce the national priorities •

Measure progress and impact using existing data

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Identify priorities for program improvement, reporting and technical assistance

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Facilitate evidence based practices•

Enhance collaboration among partners at all levels

Summary

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Acknowledgements

Robert PrattValerie RobisonMaria RodriguezTom ShinnickTeresa SmithDeborah Sodt Barbara StoneWendy SutherlandZach TaylorWanda WaltonMaureen Wilce

Subroto BanerjiJose BecerraJames L Beebe Janice Boutotte Melissa Ehman Kim Field Katie Garman Phil Griffin Cathy GoldsboroughChristopher Hayden Marge HigginsCarol HoffErin Holt

Stephen HughesKashef IjazJohn JerebBillie Juni Awal KhanBeth Kingdon Linda LearyPhil LoBueBeverly MetchockHeather Morrow-

AlmeidaMassa NaritaTom Navin

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Access NTIP

TB Controllers e-mail their respective program consultants requesting access for staff member

https://66.155.122.64/ntip/nt/session/login.do

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Virginia NTIP in TB Control and Program Evaluation

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Treatment Completion in 12 Months

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Treatment Outcomes

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VA Program Evaluation Framework, 2008

Determine reasons that contacts •

Not identified

•

With LTBI not started on treatment

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Contacts Elicited

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Contacts with LTBI Starting Treatment

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Contacts by Disposition

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Program Evaluation DTBE Approach

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Field Services and Evaluation Branch (FSEB)

Kashef Ijaz MDChief

Joe ScavottoDeputy

Field Operations IGreg Andrews

Team Lead

Field Operations IIDan RuggieroTeam Lead

Program Evaluation Awal Khan, PhD

Team Lead

Medical AffairsSundari Mase, MD

Team Lead

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TB Program Consultant (PC) and Evaluation Team Rep (ER) Assignment for Technical Support by Consulting Regions

VIIPC: Paul TribbleER: Kai Young

(AK, CO ID, MT, NV, OR, UT, WA, WY)

VIIIPC: Andy Heetderks

ER: Judy Gibson*/Awal Khan(CA, Los Angeles, San Diego,

San Francisco,Awal (HI, AS, FM, GU, MH, MP, PW)

VIPC: Mark Miner

ER: Judy Gibson*(AZ, KS, NM, OK, TX, Houston)

IIPC: Vic Tomlinson

ER: Awal Khan(Baltimore, DC, DE, MD, NCPA, Philadelphia, VA, WV)

IIIPC: Gail Burns-Grant

ER: Awal Khan(AL, AR, FL, GA, LA, MS, SC, TN)

IVPC: Bruce HeathER: Linda Leary*

(KY, MI, Detroit, MN, ND, SD, WI, Puerto Rico, Virgin Islands)

IPC: Dawn Tuckey

ER: Kai Young(CT, ME, MA, NH, RI, VT, NY, NJ,NYC)

VPC: Regina GoreER: Linda Leary*

(IA, IL, IN, MO, NE, OH, Chicago)

*Backup supports: Kai Young for Linda Leary; Awal Khan for Judy Gibson

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Collaborative Approach -

Evaluation

State/LocalTB Program

National Goalsand Objectives

Evaluation Activity

(Cohort Review)

1-5 yr Plan

Program Consultant

Evaluation Team

NTIP

PENFocal point

ETN Focal point

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PET Activities and Services

Help state and local TB programs develop

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Goals and objectives•

An evaluation plan and logic model

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Evaluation questions and performance indicators

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Data collection methods, instrument, and analysis plan

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PET Activities and Services (cont.)

Assist state and local TB programs

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Monitor program goals and objectives•

Identify priority areas of program improvement

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Identify implementation gaps / promote best practices

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Provide feedback, input on PE capacity building activities

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Identify training, educational needs for staff

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PET Activities and Services (cont.)

Support TB Program Evaluation Network(TB PEN) Steering Committee in program

evaluation activities.

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Program Evaluation Focal Point

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Designated point of contact for evaluation activities in COAG site by March 2010

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Serves as the subject matter expert

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Participates in TB Program Evaluation Network (TB PEN)

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Shares experiences and lessons learned

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Facilitates program evaluation capacity building

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TB Evaluation Products

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Any Questions?

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