A logic model is a tool that can be used in planning a program. Using a logic model, social workers can systematically analyze a proposed new program and how the various elements involved in a program relate to each other. At the program level, social workers consider the range of problems and needs that members of a particular population present. Furthermore, at the program level, the logic model establishes the connection between the resources needed for the program, the planned interventions, the anticipated outcomes, and ways of measuring success. The logic model provides a clear picture of the program for all stakeholders involved.
To prepare for this Assignment, review the case study of the Petrakis family, located in this week’s resources. Conduct research to locate information on an evidence-based program for caregivers like Helen Petrakis that will help you understand her needs as someone who is a caregiver for multiple generations of her family. You can use the NREPP registry. Use this information to generate two logic models for a support group that might help Helen manage her stress and anxiety.
First, consider the practice level. Focus on Helen’s needs and interventions that would address those needs and lead to improved outcomes. Then consider the support group on a new program level. Think about the resources that would be required to implement such a program (inputs) and about how you can measure the outcomes.
Submit the following:
Decisions that would need to be made about characteristics of group membership
Group activities
Ways to measure the outcomes
Read the following section: “The Petrakis Family”
The Petrakis Family
Helen Petrakis is a 52-year-old heterosexual married female of Greek descent who says that she feels overwhelmed and “blue.” She came to our agency at the suggestion of a close friend who thought Helen would benefit from having a person who could listen. Although she is uncomfortable talking about her life with a stranger, Helen said that she decided to come for therapy because she worries about burdening friends with her troubles. Helen and I have met four times, twice per month, for individual therapy in 50-minute sessions.
Helen consistently appears well-groomed. She speaks clearly and in moderate tones and seems to have linear thought progression; her memory seems intact. She claims no history of drug or alcohol abuse, and she does not identify a history of trauma. Helen says that other than chronic back pain from an old injury, which she manages with acetaminophen as needed, she is in good health.
Helen has worked full time at a hospital in the billing department since graduating from high school. Her husband, John (60), works full time managing a grocery store and earns the larger portion of the family income. She and John live with their three adult children in a 4-bedroom house. Helen voices a great deal of pride in the children. Alec, 27, is currently unemployed, which Helen attributes to the poor economy. Dmitra, 23, whom Helen describes as smart, beautiful, and hardworking, works as a sales consultant for a local department store. Athina, 18, is an honors student at a local college and earns spending money as a hostess in a family friend’s restaurant; Helen describes her as adorable and reliable.
In our first session, I explained to Helen that I was an advanced year intern completing my second field placement at the agency. I told her I worked closely with my field supervisor to provide the best care possible. She said that was fine, congratulated me on advancing my career, and then began talking. I listened for the reasons Helen came to speak with me.
I asked Helen about her community, which, she explained, centered on the activities of the Greek Orthodox Church. She and John were married in that church and attend services weekly. She expects that her children will also eventually wed there. Her children, she explained, are religious but do not regularly go to church because they are very busy. She believes that the children are too busy to be expected to help around the house. Helen shops, cooks, and cleans for the family, and John sees to yard care and maintains the family’s cars. When I asked whether the children contributed to the finances of the home, Helen looked shocked and said that John would find it deeply insulting to take money from his children. As Helen described her life, I surmised that the Petrakis family holds strong family bonds within a large and supportive community.
Helen is responsible for the care of John’s 81-year-old widowed mother, Magda, who lives in an apartment 30 minutes away. Until recently, Magda was self-sufficient, coming for weekly family dinners and driving herself shopping and to church. But 6 months ago, she fell and broke her hip and was also recently diagnosed with early signs of dementia. Through their church, Helen and John hired a reliable and trusted woman to check in on Magda a couple of days each week. Helen goes to see Magda on the other days, sometimes twice in one day, depending on Magda’s needs. She buys her food, cleans her home, pays her bills, and keeps track of her medications. Helen says she would like to have the helper come in more often, but she cannot afford it. The money to pay for help is coming out of the couple’s vacations savings. Caring for Magda makes Helen feel as if she is failing as a wife and mother because she no longer has time to spend with her husband and children.
Helen sounded angry as she described the amount of time she gave toward Magda’s care. She has stopped going shopping and out to eat with friends because she can no longer find the time. Lately, John has expressed displeasure with meals at home, as Helen has been cooking less often and brings home takeout. She sounded defeated when she described an incident in which her son, Alec, expressed disappointment in her because she could not provide him with clean laundry. When she cried in response, he offered to help care for his grandmother. Alec proposed moving in with Magda.
Helen wondered if asking Alec to stay with his grandmother might be good for all of them. John and Alec had been arguing lately, and Alec and his grandmother had always been very fond of each other. Helen thought she could offer Alec the money she gave Magda’s helper.
I responded that I thought Helen and Alec were using creative problem solving and utilizing their resources well in crafting a plan. I said that Helen seemed to find good solutions within her family and culture. Helen appeared concerned as I said this, and I surmised that she was reluctant to impose on her son because she and her husband seemed to value providing for their children’s needs rather than expecting them to contribute resources. Helen ended the session agreeing to consider the solution we discussed to ease the stress of caring for Magda.
The Petrakis Family
Magda Petrakis: mother of John Petrakis, 81
John Petrakis: father, 60
Helen Petrakis: mother, 52
Alec Petrakis: son, 27
Dmitra Petrakis: daughter, 23
Athina Petrakis: daughter, 18
In our second session, Helen said that her son again mentioned that he saw how overwhelmed she was and wanted to help care for Magda. While Helen was not sure this was the best idea, she saw how it might be helpful for a short time. Nonetheless, her instincts were still telling her that this could be a bad plan. Helen worried about changing the arrangements as they were and seemed reluctant to step away from her integral role in Magda’s care, despite the pain it was causing her. In this session, I helped Helen begin to explore her feelings and assumptions about her role as a caretaker in the family. Helen did not seem able to identify her expectations of herself as a caretaker. She did, however, resolve her ambivalence about Alec’s offer to care for Magda. By the end of the session, Helen agreed to have Alec live with his grandmother.
In our third session, Helen briskly walked into the room and announced that Alec had moved in with Magda and it was a disaster. Since the move, Helen had had to be at the apartment at least once daily to intervene with emergencies. Magda called Helen at work the day after Alec moved in to ask Helen to pick up a refill of her medications at the pharmacy. Helen asked to speak to Alec, and Magda said he had gone out with two friends the night before and had not come home yet. Helen left work immediately and drove to Magda’s home. Helen angrily told me that she assumed that Magda misplaced the medications, but then she began to cry and said that the medications were not misplaced, they were really gone. When she searched the apartment, Helen noticed that the cash box was empty and that Magda’s checkbook was missing two checks. Helen determined that Magda was robbed, but because she did not want to frighten her, she decided not to report the crime. Instead, Helen phoned the pharmacy and explained that her mother-in-law, suffering from dementia, had accidently destroyed her medication and would need refills. She called Magda’s bank and learned that the checks had been cashed. Helen cooked lunch for her mother-in-law and ate it with her. When a tired and disheveled Alec arrived back in the apartment, Helen quietly told her son about the robbery and reinforced the importance of remaining in the building with Magda at night.
Helen said that the events in Magda’s apartment were repeated 2 days later. By this time in the session Helen was furious. With her face red with rage and her hands shaking, she told me that all this was my fault for suggesting that Alec’s presence in the apartment would benefit the family. Jewelry from Greece, which had been in the family for generations, was now gone. Alec would never be in this trouble if I had not told Helen he should be permitted to live with his grandmother. Helen said she should know better than to talk to a stranger about private matters.
Helen cried, and as I sat and listened to her sobs, I was not sure whether to let her cry, give her a tissue, or interrupt her. As the session was nearing the end, Helen quickly told me that Alec has struggled with maintaining sobriety since he was a teen. He is currently on 2 years’ probation for possession and had recently completed a rehabilitation program. Helen said she now realized Alec was stealing from his grandmother to support his drug habit. She could not possibly tell her husband because he would hurt and humiliate Alec, and she would not consider telling the police. Helen’s solution was to remove the valuables and medications from the apartment and to visit twice a day to bring supplies and medicine and check on Alec and Magda.
After this session, it was unclear how to proceed with Helen. I asked my field instructor for help. I explained that I had offered support for a possible solution to Helen’s difficulties and stress. In rereading the progress notes in Helen’s chart, I realized I had misinterpreted Helen’s reluctance to ask Alec to move in with his grandmother. I felt terrible about pushing Helen into acting outside of her own instincts.
My field instructor reminded me that I had not forced Helen to act as she had and that no one was responsible for the actions of another person. She told me that beginning social workers do make mistakes and that my errors were part of a learning process and were not irreparable. I was reminded that advising Helen, or any client, is ill-advised. My field instructor expressed concern about my ethical and legal obligations to protect Magda. She suggested that I call the county office on aging and adult services to research my duty to report, and to speak to the agency director about my ethical and legal obligations in this case.
In our fourth session, Helen apologized for missing a previous appointment with me. She said she awoke the morning of the appointment with tightness in her chest and a feeling that her heart was racing. John drove Helen to the emergency room at the hospital in which she works. By the time Helen got to the hospital, she could not catch her breath and thought she might pass out. The hospital ran tests but found no conclusive organic reason to explain Helen’s symptoms.
I asked Helen how she felt now. She said that since her visit to the hospital, she continues to experience shortness of breath, usually in the morning when she is getting ready to begin her day. She said she has trouble staying asleep, waking two to four times each night, and she feels tired during the day. Working is hard because she is more forgetful than she has ever been. Her back is giving her trouble, too. Helen said that she feels like her body is one big tired knot.
I suggested that her symptoms could indicate anxiety and she might want to consider seeing a psychiatrist for an evaluation. I told Helen it would make sense, given the pressures in her life, that she felt anxiety. I said that she and I could develop a treatment plan to help her address the anxiety. Helen’s therapy goals include removing Alec from Magda’s apartment and speaking to John about a safe and supported living arrangement for Magda.
Plummer, Sara-Beth, Sara Makris, Sally Brocksen. Sessions: Case Histories. Laureate Publishing, 02/2014. VitalBook file.
Excerptsfrom Measuring Program Outcomes: A Practical Approach
© 1996 United Way of America
Introduction to Outcome Measurement
If yours is like most human service agencies or youth- and family-serving organizations, you regularly
monitor and report on how much money you receive, how many staff and volunteers you have, and what
they do in your programs. You know how many individuals participate in your programs, how many hours
you spend serving them, and how many brochures or classes or counseling sessions you produce. In
other words, you document program inputs, activities, and outputs.
Inputs include resources dedicated to or consumed by the program. Examples are money, staff and staff
time, volunteers and volunteer time, facilities, equipment, and supplies. For instance, inputs for a parent
education class include the hours of staff time spent designing and delivering the program. Inputs also
include constraints on the program, such as laws, regulations, and requirements for receipt of funding.
Activities are what the program does with the inputs to fulfill its mission. Activities include the strategies,
techniques, and types of treatment that comprise the program’s service methodology. For instance,
sheltering and feeding homeless families are program activities, as are training and counseling homeless
adults to help them prepare for and find jobs.
Outputs are the direct products of program activities and usually are measured in terms of the volume of
work accomplished–for example, the numbers of classes taught, counseling sessions conducted,
educational materials distributed, and participants served. Outputs have little inherent value in
themselves. They are important because they are intended to lead to a desired benefit for participants or
target populations.
If given enough resources, managers can control output levels. In a parent education class, for example,
the number of classes held and the number of parents served are outputs. With enough staff and
supplies, the program could double its output of classes and participants.
If yours is like most human service organizations, you do not consistently track what happens to
participants after they receive your services. You cannot report, for example, that 55 percent of your
participants used more appropriate approaches to conflict management after your youth development
program conducted sessions on that skill, or that your public awareness program was followed by a 20
percent increase in the number of low-income parents getting their children immunized. In other words,
you do not have much information on your program’s outcomes.
Outcomes are benefits or changes for individuals or populations during or after participating in program
activities. They are influenced by a program’s outputs. Outcomes may relate to behavior, skills,
knowledge, attitudes, values, condition, or other attributes. They are what participants know, think, or can
do; or how they behave; or what their condition is, that is different following the program.
For example, in a program to counsel families on financial management, outputs–what the service
produces–include the number of financial planning sessions and the number of families seen. The
desired outcomes–the changes sought in participants’ behavior or status–can include their developing
and living within a budget, making monthly additions to a savings account, and having increased financial
stability.
In another example, outputs of a neighborhood clean-up campaign can be the number of organizing
meetings held and the number of weekends dedicated to the clean-up effort. Outcomes–benefits to the
target population–might include reduced exposure to safety hazards and increased feelings of
neighborhood pride. The program outcome model depicts the relationship between inputs, activities,
outputs, and outcomes.
Note: Outcomes sometimes are confused with outcome indicators, specific items of data that are tracked to measure how well a
program is achieving an outcome, and with outcome targets, which are objectives for a program’s level of achievement.
For example, in a youth development program that creates internship opportunities for high school youth, an outcome might be that
participants develop expanded views of their career options. An indicator of how well the program is succeeding on this outcome
could be the number and percent of participants who list more careers of interest to them at the end of the program than they did at
the beginning of the program. A target might be that 40 percent of participants list at least two more careers after completing the
program than they did when they started it.
Program Outcome Model
Resources dedicated
to or consumed by
the program
money
staff and staff time
volunteers and
volunteer time
facilities
equipment and
supplies
Constraints on the
program
laws
regulations
funders’ requirements
What the program
does with the inputs
to fulfill its mission
feed and shelter
homeless families
provide job training
educate the public
about signs of child
abuse
counsel pregnant
women
create mentoring
relationships for youth
The direct products of
program activities
number of classes
taught
number of counseling
sessions conducted
number of educational
materials distributed
number of hours of
service delivered
number of participants
served
Benefits for
participants during
and after program
activities
new knowledge
increased skills
changed attitudes or
values
modified behavior
improved condition
altered status
Why Measure Outcomes?
In growing numbers, service providers, governments, other funders, and the public are calling for clearer
evidence that the resources they expend actually produce benefits for people. Consumers of services and
volunteers who provide services want to know that programs to which they devote their time really make a
difference. That is, they want better accountability for the use of resources. One clear and compelling
answer to the question of “why measure outcomes?” is to see if programs really make a difference in the
lives of people.
Although improved accountability has been a major force behind the move to outcome measurement,
there is an even more important reason: to help programs improve services. Outcome measurement
provides a learning loop that feeds information back into programs on how well they are doing. It offers
findings they can use to adapt, improve, and become more effective.
This dividend doesn’t take years to occur. It often starts appearing early in the process of setting up an
outcome measurement system. Just the process of focusing on outcomes–on why the program is doing
what it’s doing and how participants will be better off–gives program managers and staff a clearer picture
of the purpose of their efforts. That clarification alone frequently leads to more focused and productive
service delivery.
Down the road, being able to demonstrate that their efforts are making a difference for people pays
important dividends for programs. It can, for example, help programs:
• Recruit and retain talented staff
• Enlist and motivate able volunteers
• Attract new participants
• Engage collaborators
• Garner support for innovative efforts
• Win designation as a model or demonstration site
• Retain or increase funding
• Gain favorable public recognition
Results of outcome measurement show not only where services are being effective for participants, but
also where outcomes are not as expected. Program managers can use outcome data to:
• Strengthen existing services
• Target effective services for expansion
• Identify staff and volunteer training needs
• Develop and justify budgets
• Prepare long-range plans
• Focus board members’ attention on programmatic issues
To increase its internal efficiency, a program needs to track its inputs and outputs. To assess compliance
with service delivery standards, a program needs to monitor activities and outputs. But to improve its
effectiveness in helping participants, to assure potential participants and funders that its programs
produce results, and to show the general public that it produces benefits that merit support, an agency
needs to measure its outcomes.
These and other benefits of outcome measurement are not just theoretical. Scores of human service
providers across the country attest to the difference it has made for their staff, their volunteers, their
decision makers, their financial situation, their reputation, and, most important, for the public they serve.
Eight Steps to Success
Measuring Program Outcomes provides a step-by-step approach to developing a system for measuring
program outcomes and using the results. The approach, based on methods implemented successfully by
agencies across the country, is presented in eight steps, shown below. Although the illustration suggests
that the steps are sequential, this is actually a dynamic process with a good deal of interplay among
stages.
Example Outcomes and Outcome Indicators for Various Programs
These are illustrative examples only. Programs need to identify their own outcomes and indicators,
matched to and based on their own experiences and missions and the input of their staff, volunteers,
participants, and others.
Type of Program Outcome Indicator(s)
Smoking cessation
class
Participants stop smoking. • Number and percent of participants who report that they have quit smoking by
the end of the course
• Number and percent of participants who have not relapsed six months after
program completion
Information and
referral program
Callers access services to which
they are referred or about which
they are given information.
• Number and percent of community agencies that report an increase in new
participants who came to their agency as a result of a call to the information
and referral hotline
• Number and percent of community agencies that indicate these referrals are
appropriate
Tutorial program
for 6th grade
students
Students’ academic performance
improves.
• Number and percent of participants who earn better grades in the grading
period following completion of the program than in the grading period
immediately preceding enrollment in the program
English-as-a-
second-language
instruction
Participants become proficient in
English.
• Number and percent of participants who demonstrate increase in ability to
read, write, and speak English by the end of the course
Counseling for
parents identified
as at risk for child
abuse or neglect
Risk factors decrease. No
confirmed incidents of child
abuse or neglect.
• Number and percent of participating families for whom Child Protective
Service records report no confirmed child abuse or neglect during 12 months
following program completion
Employee
assistance
program
Employees with drug and/or
alcohol problems are
rehabilitated and do not lose
their jobs.
• Number and percent of program participants who are gainfully employed at
same company 6 months after intake
Homemaking
services
The home environment is
healthy, clean, and safe.
Participants stay in their own
home and are not referred to a
nursing home.
• Number and percent of participants whose home environment is rated clean
and safe by a trained observer
• Number of local nursing homes who report that applications from younger
and healthier citizens are declining (indicating that persons who in the past
would have been referred to a nursing home now stay at home longer)
Prenatal care
program
Pregnant women follow the
advice of the nutritionist.
• Number and percent of women who take recommended vitamin supplements
and consume recommended amounts of calcium
Shelter and
counseling for
runaway youth
Family is reunified whenever
possible; otherwise, youths are
in stable alternative housing.
• Number and percent of youth who return home
• Number and percent of youth placed in alternative living arrangements who
are in that arrangement 6 months later unless they have been reunified or
emancipated
Camping Children expand skills in areas
of interest to them.
• Number and percent of campers that identify two or more skills they have
learned at camp
Family planning for
teen mothers
Teen mothers have no second
pregnancies until they have
completed high school and have
the personal, family, and
financial resources to support a
second child.
• Number and percent of teen mothers who comply with family planning visits
• Number and percent of teen mothers using a recommended form of birth
control
• Number and percent of teen mothers who do not have repeat pregnancies
prior to graduation
• Number and percent of teen mothers who, at the time of next pregnancy, are
high school graduates, are married, and do not need public assistance to
provide for their children
Glossary of Selected Outcome Measurement Terms
Inputs are resources a program uses to achieve program objectives. Examples are staff, volunteers,
facilities, equipment, curricula, and money. A program uses inputs to support activities.
Activities are what a program does with its inputs-the services it provides-to fulfill its mission. Examples
are sheltering homeless families, educating the public about signs of child abuse, and providing adult
mentors for youth. Program activities result in outputs.
Outputs are products of a program’s activities, such as the number of meals provided, classes taught,
brochures distributed, or participants served. A program’s outputs should produce desired outcomes for
the program’s participants.
Outcomes are benefits for participants during or after their involvement with a program. Outcomes may
relate to knowledge, skills, attitudes, values, behavior, condition, or status. Examples of outcomes include
greater knowledge of nutritional needs, improved reading skills, more effective responses to conflict,
getting a job, and having greater financial stability.
For a particular program, there can be various “levels” of outcomes, with initial outcomes leading to
longer-term ones. For example, a youth in a mentoring program who receives one-to-one encouragement
to improve academic performance may attend school more regularly, which can lead to getting better
grades, which can lead to graduating.
Outcome indicators are the specific items of information that track a program’s success on outcomes.
They describe observable, measurable characteristics or changes that represent achievement of an
outcome. For example, a program whose desired outcome is that participants pursue a healthy lifestyle
could define “healthy lifestyle” as not smoking; maintaining a recommended weight, blood pressure, and
cholesterol level; getting at least two hours of exercise each week; and wearing seat belts consistently.
The number and percent of program participants who demonstrate these behaviors then is an indicator of
how well the program is doing with respect to the outcome.
Outcome targets are numerical objectives for a program’s level of achievement on its outcomes. After a
program has had experience with measuring outcomes, it can use its findings to set targets for the
number and percent of participants expected to achieve desired outcomes in the next reporting period. It
also can set targets for the amount of change it expects participants to experience.
Benchmarks are performance data that are used for comparative purposes. A program can use its own
data as a baseline benchmark against which to compare future performance. It also can use data from
another program as a benchmark. In the latter case, the other program often is chosen because it is
exemplary and its data are used as a target to strive for, rather than as a baseline.
Complete the tables below to develop both a practice-level logic model and a program-level logic model to address the needs of Helen in the Petrakis case history.
|
Problem |
Needs |
Underlying Causes |
Intervention Activities |
Outcomes |
|||||
Problem
Needs
Underlying Causes
Intervention Activities
Outcomes
© 2014 Laureate Education, Inc.
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