| Course | HLTH 8475 Advanced Program Implementation and Evaluation |
|---|---|
| Week | Week 5 |
| Paper type | Measurement plan |
| Length | About 840 words, 6 pages |
| Format | APA 7 student paper |
| School | Walden University |
| Program | PhD in Public Health |
| Updated | October 2026 |
Free sample paper for HLTH 8475 Week 5
Measurement Plan: Implementation Outcomes and a Clinical Outcome for the Rural Pharmacy PrEP Program, Each With a Source, a Recorder, a Schedule and a Level Set Before the First Client Is Seen
Student Name
Walden University
HLTH 8475: Advanced Program Implementation and Evaluation
Instructor Name
Month Day, Year
Measurement Plan: Implementation Outcomes and a Clinical Outcome for the Rural Pharmacy PrEP Program, Each With a Source, a Recorder, a Schedule and a Level Set Before the First Client Is Seen
Why Set the Plan Now
Indicators chosen after delivery begins tend to measure whatever turned out well. Here every measure is fixed in advance, its source, the person who records it, its schedule and the level that will count as success before any client is seen. Implementation outcomes are measured separately from the clinical outcome, following the distinction Proctor et al. (2011) drew between outcomes that show whether a program was delivered and outcomes that show whether it helped.
The Measures
Table 1
Measures, Sources, Recorders, Schedules and Pre-Set Levels
| Outcome | Measure | Source | Recorder | Schedule | Pre-set level | |
|---|---|---|---|---|---|
| Adoption | Share of trained pharmacists who see at least one PrEP client in the first quarter | Pharmacy service log | Site champion | Quarterly | At least 75% | |
| Acceptability | Pharmacists' ratings on a four-item acceptability scale | Short survey | Coordinator | At launch and six months | Mean of 4 or higher on a 5-point scale | |
| Feasibility | Pharmacists' ratings on a four-item feasibility scale | Short survey | Coordinator | At launch and six months | Mean of 4 or higher | |
| Reach | Share of people referred by disease intervention specialists or primary care who start PrEP within 30 days | Referral log matched to pharmacy records | District epidemiologist | Monthly | At least 50% | |
| Fidelity | Refills with a current negative HIV result on file first | Pharmacy records matched to lab results | Coordinator | Monthly audit of all refills | At least 95% | |
| Sustainability | Share of PrEP visits billed to an insurer or covered by the assistance pathway | Billing records | District billing staff | Quarterly | At least 90% | |
| Clinical: persistence | Share of clients starting PrEP who have at least 80% of days covered by dispensed medication at six months | Dispensing records | District epidemiologist | Six months after each start | At least 60% | |
| Clinical: safety | New HIV diagnoses among clients on PrEP | Lab results and state surveillance match | District epidemiologist | Quarterly | Zero, with every case reviewed | |
Levels were set by the program team with the medical director before launch and recorded in the blueprint.
Where the Levels Come From
Each level reflects either a protocol requirement or a judgment about what would make the program worth continuing. The fidelity level is close to 100% because a refill without a current negative test risks drug resistance. The persistence level draws on published experience: a pharmacist-managed clinic in Seattle reported that 90% of patients whose prescriptions were filled there had more than 80% of days covered, with an effective dropout rate of 25% (Tung et al., 2018). A rural program serving clients who travel farther is unlikely to match an urban clinic, so the team set 60% as a level that would still justify continuing. The reach level reflects the team's judgment that a program reaching fewer than half of referred people would need to change how referrals work.
Acceptability and Feasibility Measures
The plan uses brief, validated scales for acceptability and feasibility, four items each, developed to measure these implementation outcomes quickly (Weiner et al., 2017). They are short enough for busy pharmacists to complete and allow comparison across sites. The plan reproduces the item stems in an appendix rather than in full here.
Why Implementation and Clinical Outcomes Are Separate
If persistence is low, the program needs to know whether the problem lies in delivery, for example a site where the lab route failed, or in the program itself. Measuring fidelity, reach and sustainability separately from persistence lets the evaluation distinguish a program that was not delivered from one that was delivered and did not help.
How Records Will Be Matched
Several measures depend on matching records kept in different places. Fidelity requires matching each refill in a pharmacy's dispensing system with a lab result from the contract laboratory, by client identifier and date. Reach requires matching names on the referral log kept by disease intervention specialists with pharmacy intake records. The plan assigns the matching to the coordinator for fidelity and to the epidemiologist for reach, sets a monthly schedule and names a second person to check a random tenth of matches. Because these records include HIV-related information, matching will happen on district systems under the program's privacy plan, and only aggregate results will leave the district.
Who Sees the Results
Pharmacists will receive a monthly site report showing their own fidelity and reach alongside the program average, without naming other sites. The medical director and board will see quarterly summaries against each pre-set level. Clients and referral partners will receive a plain-language summary every six months. A measure that nobody sees cannot change practice, so the reporting schedule is part of the plan rather than an afterthought.
Outcomes Left Out
This plan leaves out community-wide HIV incidence as an outcome of the program, because the program's clients are a small share of the district's population and incidence changes for many reasons. It reports district diagnoses for context only.
References
Proctor, E., Silmere, H., Raghavan, R., Hovmand, P., Aarons, G., Bunger, A., Griffey, R., & Hensley, M. (2011). Outcomes for implementation research: Conceptual distinctions, measurement challenges, and research agenda. Administration and Policy in Mental Health and Mental Health Services Research, 38(2), 65-76. https://doi.org/10.1007/s10488-010-0319-7
Tung, E. L., Thomas, A., Eichner, A., & Shalit, P. (2018). Implementation of a community pharmacy-based pre-exposure prophylaxis service: A novel model for pre-exposure prophylaxis care. Sexual Health, 15(6), 556-561. https://doi.org/10.1071/SH18084
Weiner, B. J., Lewis, C. C., Stanick, C., Powell, B. J., Dorsey, C. N., Clary, A. S., Boynton, M. H., & Halko, H. (2017). Psychometric assessment of three newly developed implementation outcome measures. Implementation Science, 12, Article 108. https://doi.org/10.1186/s13012-017-0635-3
The Walden HLTH 8475 Week 5 instructions
Students design a measurement plan for their program before delivery begins. The plan should name each measure, its data source, who records it, when and the level that will count as success, set in advance. Faculty expect implementation outcomes to be measured separately from clinical outcomes, and the reasoning behind each level to be stated. Validated instruments should be cited where used. The plan should explain how records will be matched and who will see the results. Saying what the plan will not measure, and why, shows judgment about what the program can plausibly affect. Levels borrowed from published programs should be adjusted for the setting, with the adjustment explained.
Inside the HLTH 8475 Week 5 example
The opening explains why measures and levels are set before delivery and cites Proctor and colleagues. Table 1 lists eight outcomes with measure, source, recorder, schedule and pre-set level. A section explains where the levels come from, citing Tung and colleagues for the persistence benchmark and adjusting it for rural clients. A section names the brief acceptability and feasibility scales from Weiner and colleagues. A section explains why implementation and clinical outcomes are kept apart. A new section describes how dispensing, lab, referral and billing records will be matched under the privacy plan. Another sets out who sees which results. A closing section explains why community-wide incidence is reported for context only.
Where the marks sit in the HLTH 8475 Week 5 rubric
Measurement plans are graded on whether they protect the evaluation from reading success into whatever happens. A plan that names indicators without levels, or sets levels after seeing data, earns limited credit. The rubric rewards complete rows, reasoned levels, validated instruments and a clear separation of implementation from clinical outcomes. Faculty value attention to how records will be matched, especially when sensitive data are involved. A reporting plan that puts results in front of the people who can act on them shows the author expects the plan to guide decisions. Honesty about what the program cannot affect strengthens the plan. Faculty also check that each level could be reached or missed, so that the measure can actually tell the board something.
Common HLTH 8475 Week 5 mistakes, and how to avoid them
Measurement plans often list many indicators and few thresholds, which lets any result be described as a success. Others measure only the clinical outcome, so a poor result cannot be explained. To write a stronger plan, list your implementation and clinical outcomes separately. For each, name the source, recorder and schedule. Set a level before delivery and say why. Cite validated instruments. Explain how you will match records. Say who will see results. Name what you will not measure. Ask whether each level could realistically be missed. If a measurement plan with pre-set levels would help, we can build one for your program.
Get a HLTH 8475 Week 5 example written to your instructions
Send the Week 5 prompt, the rubric and your logic model or its arrow list; indicators are written against those arrows. A first sample is free and returns within 24-48h. Registry sizes, clinic targets and any baseline from a real program appear as marked slots, filled later from records you are permitted to use.
More HLTH 8475 papers and PhD in Public Health samples
- HLTH 8475 Week 1: Clearances Framing Post
- HLTH 8475 Week 2: Program Adaptation Post
- HLTH 8475 Week 3: Implementation Logic Model
- HLTH 8475 Week 4: Staged Implementation Plan
- HLTH 8475 Week 6: Reach Measure Peer Critique
- HLTH 8475 Week 7: Six-Month Process Evaluation
- HLTH 8475 Week 8: Rival Explanations Post
- HLTH 8475 Week 9: Site-Level Outcome Analysis
- HLTH 8475 Week 10: Program Failure Counterargument
- HLTH 8475 Week 11: Utilization-Focused Evaluation Report
- HLTH 8402 Week 5: Outreach Team Faultline Analysis
- HLTH 8392 Week 5: Weekend Rotation Message Design
- HLTH 8317 Week 5: Matching Requirement Analysis
- HLTH 8247 Week 5: Visiting Policy Group Analysis
HLTH 8475 Week 5 questions, answered
Where do the pre-set levels come from?
From the program's purpose and whatever published work fits it, never from numbers picked because they will be met. The sample gives the reasoning behind each level, such as what share of eligible adults would make the program worth a clinic's effort, and leaves the figure itself as a slot where your section or agency supplies the value.
Are the acceptability measures reproduced in full?
The sample names the published brief measures and says who completes them and when, without reproducing their items. Most classrooms want an instrument cited rather than copied. If the assignment wants an appendix of instruments, the sample marks where each would sit and notes any permission a published measure may require.
Where can I find a free HLTH 8475 Week 5 sample paper?
You can read the complete Week 5 measurement plan here; it sets sources, recorders, schedules and pre-set levels for a rural pharmacy PrEP program's implementation and clinical outcomes, with three references.
Why are implementation outcomes measured separately from persistence on PrEP?
Because low persistence means different things depending on delivery: if fidelity and reach were high, it says something about the program; if they were low, it may only show the program was not fully delivered.
Where does the persistence level come from?
From published experience at a pharmacist-managed PrEP clinic, adjusted for a rural setting where travel and privacy make follow-up harder; the paper explains the adjustment.