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TM Program Evaluation: Using National TB Indicators Project (NTIP) Judy Gibson, MSN, RN Program 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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Program Evaluation: Using National TB Indicators … · TM. Presentation Outline • Describe NTIP and the National TB Program Objectives • Understand importance of NTIP in TB control

Jul 19, 2018

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Page 1: Program Evaluation: Using National TB Indicators … · TM. Presentation Outline • Describe NTIP and the National TB Program Objectives • Understand importance of NTIP in TB control

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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

Page 2: Program Evaluation: Using National TB Indicators … · TM. Presentation Outline • Describe NTIP and the National TB Program Objectives • Understand importance of NTIP in TB control

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Presentation Outline

Describe NTIP and the National TB Program Objectives

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

Describe CDC/DTBE Program Evaluation (PE) approach

Page 3: Program Evaluation: Using National TB Indicators … · TM. Presentation Outline • Describe NTIP and the National TB Program Objectives • Understand importance of NTIP in TB control

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NTIP and National TB Program Objectives

Page 4: Program Evaluation: Using National TB Indicators … · TM. Presentation Outline • Describe NTIP and the National TB Program Objectives • Understand importance of NTIP in TB control

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Page 5: Program Evaluation: Using National TB Indicators … · TM. Presentation Outline • Describe NTIP and the National TB Program Objectives • Understand importance of NTIP in TB control

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What is NTIP?

A program monitoring system•

Indicator reports-

inform progress toward national objectives

-

focus program evaluation efforts-

provide performance targets as benchmark for

assessment

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

Page 6: Program Evaluation: Using National TB Indicators … · TM. Presentation Outline • Describe NTIP and the National TB Program Objectives • Understand importance of NTIP in TB control

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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

Page 7: Program Evaluation: Using National TB Indicators … · TM. Presentation Outline • Describe NTIP and the National TB Program Objectives • Understand importance of NTIP in TB control

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Selecting Potential NTIP Objectives

Stakeholders submitted wide range of objectives

Focus only on those with existing data•

Result: 28 potential objectives

Stakeholders ranked and grouped objectives into 15 categories

Page 8: Program Evaluation: Using National TB Indicators … · TM. Presentation Outline • Describe NTIP and the National TB Program Objectives • Understand importance of NTIP in TB control

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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

Targets to be agreed on with DTBE consultants

Establishing NTIP Targets

Page 9: Program Evaluation: Using National TB Indicators … · TM. Presentation Outline • Describe NTIP and the National TB Program Objectives • Understand importance of NTIP in TB control

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National TB Program Objectives 2015

Page 10: Program Evaluation: Using National TB Indicators … · TM. Presentation Outline • Describe NTIP and the National TB Program Objectives • Understand importance of NTIP in TB control

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NationalObjective

State Performance

Graph

State Data

Method

Page 11: Program Evaluation: Using National TB Indicators … · TM. Presentation Outline • Describe NTIP and the National TB Program Objectives • Understand importance of NTIP in TB control

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Example: TB Treatment Completion

Page 12: Program Evaluation: Using National TB Indicators … · TM. Presentation Outline • Describe NTIP and the National TB Program Objectives • Understand importance of NTIP in TB control

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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

Page 13: Program Evaluation: Using National TB Indicators … · TM. Presentation Outline • Describe NTIP and the National TB Program Objectives • Understand importance of NTIP in TB control

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Example: Know HIV Status

Page 14: Program Evaluation: Using National TB Indicators … · TM. Presentation Outline • Describe NTIP and the National TB Program Objectives • Understand importance of NTIP in TB control

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Example: Know HIV Status (cont)

Page 15: Program Evaluation: Using National TB Indicators … · TM. Presentation Outline • Describe NTIP and the National TB Program Objectives • Understand importance of NTIP in TB control

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Example: Contact Investigation

Page 16: Program Evaluation: Using National TB Indicators … · TM. Presentation Outline • Describe NTIP and the National TB Program Objectives • Understand importance of NTIP in TB control

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Example: Drug Susceptibility Results

Page 17: Program Evaluation: Using National TB Indicators … · TM. Presentation Outline • Describe NTIP and the National TB Program Objectives • Understand importance of NTIP in TB control

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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

Page 18: Program Evaluation: Using National TB Indicators … · TM. Presentation Outline • Describe NTIP and the National TB Program Objectives • Understand importance of NTIP in TB control

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NTIP will

Reinforce the national priorities •

Measure progress and impact using existing data

Identify priorities for program improvement, reporting and technical assistance

Facilitate evidence based practices•

Enhance collaboration among partners at all levels

Summary

Page 19: Program Evaluation: Using National TB Indicators … · TM. Presentation Outline • Describe NTIP and the National TB Program Objectives • Understand importance of NTIP in TB control

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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

Page 20: Program Evaluation: Using National TB Indicators … · TM. Presentation Outline • Describe NTIP and the National TB Program Objectives • Understand importance of NTIP in TB control

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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

Page 21: Program Evaluation: Using National TB Indicators … · TM. Presentation Outline • Describe NTIP and the National TB Program Objectives • Understand importance of NTIP in TB control

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Virginia NTIP in TB Control and Program Evaluation

Page 22: Program Evaluation: Using National TB Indicators … · TM. Presentation Outline • Describe NTIP and the National TB Program Objectives • Understand importance of NTIP in TB control

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Treatment Completion in 12 Months

Page 23: Program Evaluation: Using National TB Indicators … · TM. Presentation Outline • Describe NTIP and the National TB Program Objectives • Understand importance of NTIP in TB control

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Treatment Outcomes

Page 24: Program Evaluation: Using National TB Indicators … · TM. Presentation Outline • Describe NTIP and the National TB Program Objectives • Understand importance of NTIP in TB control

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VA Program Evaluation Framework, 2008

Determine reasons that contacts •

Not identified

With LTBI not started on treatment

Page 25: Program Evaluation: Using National TB Indicators … · TM. Presentation Outline • Describe NTIP and the National TB Program Objectives • Understand importance of NTIP in TB control

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Contacts Elicited

Page 26: Program Evaluation: Using National TB Indicators … · TM. Presentation Outline • Describe NTIP and the National TB Program Objectives • Understand importance of NTIP in TB control

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Contacts with LTBI Starting Treatment

Page 27: Program Evaluation: Using National TB Indicators … · TM. Presentation Outline • Describe NTIP and the National TB Program Objectives • Understand importance of NTIP in TB control

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Contacts by Disposition

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Program Evaluation DTBE Approach

Page 29: Program Evaluation: Using National TB Indicators … · TM. Presentation Outline • Describe NTIP and the National TB Program Objectives • Understand importance of NTIP in TB control

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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

Page 30: Program Evaluation: Using National TB Indicators … · TM. Presentation Outline • Describe NTIP and the National TB Program Objectives • Understand importance of NTIP in TB control

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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

Page 31: Program Evaluation: Using National TB Indicators … · TM. Presentation Outline • Describe NTIP and the National TB Program Objectives • Understand importance of NTIP in TB control

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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

Page 32: Program Evaluation: Using National TB Indicators … · TM. Presentation Outline • Describe NTIP and the National TB Program Objectives • Understand importance of NTIP in TB control

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PET Activities and Services

Help state and local TB programs develop

Goals and objectives•

An evaluation plan and logic model

Evaluation questions and performance indicators

Data collection methods, instrument, and analysis plan

Page 33: Program Evaluation: Using National TB Indicators … · TM. Presentation Outline • Describe NTIP and the National TB Program Objectives • Understand importance of NTIP in TB control

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PET Activities and Services (cont.)

Assist state and local TB programs

Monitor program goals and objectives•

Identify priority areas of program improvement

Identify implementation gaps / promote best practices

Provide feedback, input on PE capacity building activities

Identify training, educational needs for staff

Page 34: Program Evaluation: Using National TB Indicators … · TM. Presentation Outline • Describe NTIP and the National TB Program Objectives • Understand importance of NTIP in TB control

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PET Activities and Services (cont.)

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

evaluation activities.

Page 35: Program Evaluation: Using National TB Indicators … · TM. Presentation Outline • Describe NTIP and the National TB Program Objectives • Understand importance of NTIP in TB control

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Program Evaluation Focal Point

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

Serves as the subject matter expert

Participates in TB Program Evaluation Network (TB PEN)

Shares experiences and lessons learned

Facilitates program evaluation capacity building

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TB Evaluation Products

Page 37: Program Evaluation: Using National TB Indicators … · TM. Presentation Outline • Describe NTIP and the National TB Program Objectives • Understand importance of NTIP in TB control

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Any Questions?

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