CZECH INTERNET-BASED TOBACCO CONTROL: EVALUATION OF IMPACT
The impact of the Czech Internet-Based Tobacco Control Program was assessed using qualitative or process measures as well as quantitative or impact indicators. The main evaluation indicators are summarized below.
Monitoring: The project maintained details of its own training, technical assistance and program dissemination activities which provided quantitative data on the type and number of events, participants/beneficiaries in each, use of the center and each of its programs including the web site, listserv, and resource directory.
Process evaluation monitored and tracked the creation of the Internet-based Czech Tobacco-Control Training and Communications Program (TOB-CCP) in Prague, training and technical assistance to the tobacco-control community to enhance their capacity for communications, outreach and self sustainability, and fostering cooperation among Czech and international organizations through a nationwide electronic network for sharing resources, programs and services, and cooperation on tobacco-control advocacy. A comparison of planned and actual activities (below) indicates that the project fully accomplished its objectives.
Comparison of Planned and Actual accomplishments
The impact of the program is demonstrated by the evaluation of the Training workshops (Oct99, Apr 00, Jun 00) and the Tobacco-Control Network as summarized below, and within the next 6 months will also become apparent in part from the results of the fifth Monica Surveys, to be conducted in 2001 to monitor this program.
Three MONICA Surveys were completed in 1985, 1988 and 1992 with a fourth comprising a study in 1992. Key results are that since 1985, plasma cholesterol levels have decreased significantly and smoking prevalence among men has decreased and remained stable. Changes in smoking prevalence were related to social and educational status and dropped substantially in subgroups of men with university education. The fifth MONICA survey to be completed in 2001, will also analyze diet using the same protocol used in the third MONICA survey in 1992, and allow further comparisons of project.
The impact of the three principal Training Workshops (Oct99, Apr 00, Jun 00) and the Tobacco-Control Conference was evaluated using pre- and post-survey methodology. In general, questions focused on the knowledge and skills of participants before the workshop and whether there were demonstrable improvements after participating in the workshop. In addition, participants were asked whether the training met their personal goals and the frequency with which the experience obtained will be applied in their jobs. Both the content and presentation by various workshop facilitators and presenters were also evaluated.
The Internet Training Workshop (Oct99, Apr 00, Jun 00) was rated as fully accomplishing, indeed exceeding the objectives of the course. Participants gained an increased understanding of a large variety of Internet and web concepts, ranging from email to listservers, bulletins, and research and participating in online discussions. They rated the workshop as extremely helpful in reaching their personal goals and in conveying technical skills and knowledge that would be applied frequently in their own professional work (Click the chart icon to see the chart).
Active participation in the media workshop produced ready-to-print articles and statements for the Czech media. Click on the corresponding chart icon for a chart summarizing the evaluation of the Media Relations and Advocacy Workshops and the Tobacco-Control Conference for usefulness, interest and relevance, showing that most ratings are at the upper end of the scale and thus demonstrate the success of the workshops.
Figure 5 is a pooled comparison of key representative sessions from the four major workshops- Internet Training, Media Outreach and Relations, Advocacy, and Tobacco Control - shows that participants rated all of them "extremely or very helpful and/or useful."
Summarized in Figure 6 are major activities of the Tobacco Control Network resulting from its participation in the TOB-CCP. About 25 of the 40 network members participated in a final network assessment to quantify the Internet communication activities - web page visits, research, tobacco control campaigns, e-mail for professional activities, workshop participation and activities, technological connectivity, and future activities. A large majority wrote health news stories and participated in the TOB-CCP coordinated "Quit and Win" smoking cessation campaign.
A sizeable group regularly used health websites and a budding group reported contributing to tobacco control legislation. Increase in knowledge and skills as well as contacts with each other and with other health professionals, especially Internet networking, for example with Globalink, rated the highest among the gains from the formation of the network and participation in the TOB-CCP.
Overall, Internet training helped network members become technologically sophisticated in networking with experts and health professionals, obtaining health-related information and using email for communications. While a significant majority of the network demonstrated technological connectivity through daily computer access, only two-thirds have daily Internet access. About the same proportion accessed health-related websites. This limited usage points to problems of accessing the Internet, currently via telephone and the cost is high. That a sizeable majority of network members participated in writing health news stories and contacting journalists demonstrates the success of the Media Relations Workshop. The network profile strongly indicates a reticence in legislative advocacy. These limited advocacy efforts reflect the nation's current history and lack of tradition in civic participation.
The evaluation of impact demonstrates that this comprehensive series of communications and training activities fully met, indeed far exceeded the project goals and objectives. While the specific, intrinsic outcomes can benefit the public health community as well as the Czech public as a whole, the overall project can also serve as a model program and its components as templates singly or combined for future projects in other countries.
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