Similar outcomes for different interventions and multiple impacts of each intervention on abilities were observed, implying complex causal pathways.Īll the interventions were a low-cost incremental attempt to address unmet health care needs of vulnerable populations. The model helped to identify, explore and synthesize intended and unintended consequences of four interventions that appeared to have more differences than similarities. The combination of intended and observed consequences for consumers and providers was different at each site, but all sites achieved change in both consumer ability and provider capability, even in interventions where there was no activity targeting provider behaviors. All sites observed changes in patient abilities to access PHC and provider access capabilities. Using the overarching logic model, unexpected findings were reviewed, and alternative explanations were considered to understand how the mechanisms of each intervention may have contributed to results.Įach site addressed their local access problem with different strategies and from different starting points.

These sites were located in Canada (Alberta, Quebec and Ontario) and Australia (New South Wales). The analysis for this paper included four of the six sites that met study criteria. IMPACT’s evaluation used a mixed methods design with longitudinal (pre and post) analysis of six interventions. The aim of this paper is to describe what we learned about improving access to PHC for vulnerable groups across multiple sites through use of a common theory-based program logic model and a common evaluation approach. Failure to scale up effective interventions has been due, in part, to a failure to share the logic and essential elements of successful programs. Inequitable access to primary health care (PHC) remains a problem for most western countries.

Greenbooks ucf locations