Case Study Background
To walk through Steps 1-6, this toolkit uses hypothetical, Georgia-specific case study examples to illustrate the components of the CDC's evaluation framework. These case studies are based on real experiences of nonprofit health-related organizations in the state of Georgia.
There are three case studies:
- A safety net clinic evaluates a program
- A policy advocacy organization evaluates its advocacy strategy
- An organization evaluates its five-year strategic plan
The following shares some background information about each of the organizations used for the case study examples.
1) Safety net clinic case study background
Georgia Health for All is a medium-sized, federally qualified health center (FQHC) with seven paid staff and 80 clinical and non-clinical volunteers. The clinic provides free or reduced cost medical and dental services to low-income residents in a rural town in Georgia. Georgia Health for All has an electronic medical record system (EMR) and all staff and clinical volunteers have been trained how to use it. A community advisory committee helps the clinic routinely assess community needs and tailor services accordingly. Georgia Health for All also has a strong partnership with the regional hospital, which provides emergency and specialty services to the clinic’s patients.
Georgia Health for All offers many health education programs to patients, including a diabetes management program. The program has been in existence for one year and is funded by a three-year grant from a small family foundation. When Georgia Health for All patients are first diagnosed with diabetes they are referred to the diabetes management program (DMP), which provides bi-weekly group sessions led by a bilingual (English and Spanish) diabetes support team comprised of a health educator and a volunteer registered nurse (RN) or nurse practitioner. During the 2-hour group sessions, patients learn about a range of diabetes management issues, such as medication administration, blood glucose testing, and diet and physical activity recommendations. Sessions also provide an opportunity for patients to break into small groups to discuss issues of concern to them and receive advice from the support team. Attendance is voluntary, although patients are encouraged to regularly attend group sessions during their first three months after diagnosis so they can cover the full range of topics. Average attendance is about 10 patients per session.
Georgia Health for All’s leadership and board have raised questions about the program’s impact on patients’ health, as well as whether clinic use has decreased as a result of teaching patients to better manage their symptoms. Anecdotal reports from patients about the program’s positive impact on their well being are floating around the office, prompting an interest in program evaluation to confirm this.
2) Policy advocacy case study background
Georgia Pediatricians for Health is a small organization with two full-time staff and a very strong, active board of directors. Since 2005, Georgia Pediatricians for Health (GPH) has been funded primarily by health foundation grants. GPH’s mission is to advocate for state policies that support and improve children’s health. This involves engaging members (pediatricians and nurse practitioners) to actively participate in specific advocacy efforts, and collaborating with similar organizations—such as professional associations, medical/health organizations, and other child health advocacy groups—to promote policy change. In addition, GPH works directly with the state’s Medicaid office on policy issues related to PeachCare, a state children’s health insurance program.
Georgia Pediatricians for Health has moved into the final year of operations under its first five-year strategic plan, and is ready to begin its next round of strategic planning. In preparation, board members and staff are trying to determine which program strategies were most successful in facilitating statewide policy change. However, GPH staff have been unable to draw clear connections between their past advocacy activities and policy outcomes. This, in part, has to do with the difficulty of measuring the impact of advocacy work after the work has been completed. As a result, the organization has decided to design and conduct an evaluation of their upcoming efforts that will allow them to collect data as their work is underway. They want to answer the question: “To what extent are our advocacy efforts directly influencing statewide policy changes that improve children's health in Georgia?”
3) Organizational case study background
This case study is about developing an evaluation plan to evaluate an organization's progress towards goals and outcomes, as outlined in its strategic plan. To demonstrate the steps of evaluating an entire organization, a mock strategic plan will be referred to in addition to the worksheets used in the other case studies.
Healthy Eating Active Living (HEAL) Georgia is a community-based nonprofit organization that aims to improve the health of low-income Georgians. The organization uses a two-pronged approach: (1) advocating for change to improve state and local policies and systems to better support healthy diets and active lifestyles; and (2) providing programs to help individuals make behavior changes that can improve their health.
The organization is small, with its eight staff dedicated to advocacy, programming, fundraising, and partnership development. Previous evaluations have focused on individual programs and specific advocacy campaigns, and the organization has found these to be useful in improving its programs and strategies.
Now, HEAL Georgia intends to take a step back and evaluate the organization as a whole, using its five-year strategic plan as the guide.