Evidence Based Interventions Logic Models

NBCCEDP Meta-Logic Model of Priority Evidence-based Strategies and
Program Supported Activities
ACTIVITIES

SHORT-TERM OUTCOMES

Provider Assessment
and Feedback

INTERMEDIATE OUTCOMES

Increased provider recommendations
for patients to receive B&C cancer
screening consistent with guidelines

Provider
Reminders
Reducing Out of
Pocket Costs
Patient
Reminders
Reducing
Structural Barriers
Small
Media
Patient
Navigation
Community
Outreach

Improved provider knowledge of and
adherence to USPSTF B&C cancer
screening guidelines

Increased demand for B&C cancer
screening among priority population

Increased
patient
completion
of B&C
cancer
screening

Increased
health
system/
clinic B&C
cancer
screening
rates

Increased access to B&C cancer
screening for priority population

Group
Education
One-on-One
Education

Improved patient knowledge about
the need for B&C cancer screening
among priority population

Definitions/Abbreviations
USPSTF = United States Preventive Services Task Force
MIYO = “Make It Your Own” www.miyoworks.org
Research-tested messages and designs for health
communications materials

EMR = Electronic Medical Records
PN = Patient Navigation
CHWs = Community Health Workers

August 2017

CS250452-B

Provider Assessment and Feedback for the NBCCEDP – Logic Model
EVIDENCE-BASED STRATEGY
ACTIVITIES

OUTPUTS

SHORT-TERM OUTCOMES

Identify and recruit partners to
implement provider assessment
and feedback systems

Appropriate partners recruited to
implement provider assessment
and feedback systems

Increased implementation of
provider assessment and feedback
systems among health systems/
clinics within grantee service area

Obtain annual rates of B&C
cancer screening

Accurate rates of B&C cancer
screening obtained according
to CDC guidance and reported
to CDC

Increased number of primary care
clinics with accurate B&C
cancer screening rates

Educate providers* on USPSTF
B&C cancer screening guidelines

Targeted providers educated
on USPSTF B&C cancer
screening guidelines

Improved provider knowledge
of and adherence to USPSTF B&C
cancer screening guidelines

Implement system to monitor
provider performance in offering
and delivering appropriate B&C
cancer screening (ASSESSMENT)
Implement system to inform
providers at regular intervals about
their performance (FEEDBACK)

Increased provider
recommendations
for patients to
receive B&C
cancer screening
consistent with
guidelines

Provider assessment and feedback
system implemented with timely
distribution of accurate feedback
reports to primary care providers

Increased
patient
completion
of B&C cancer
screening

INTERMEDIATE OUTCOMES

Moderating factors:
• Organizational barriers (e.g.,
limited IT or EMR system)

Moderating factors:
• Structural barriers (e.g., lack of
provider referral for screening)
• Patient barriers (e.g., fear, cost)
• Limited capacity for:
• Colposcopy
• Mammography

Increased health system/clinic
B&C cancer screening rates

*The term “providers” refers to any/all clinical staff involved in implementation/use of the provider assessment and feedback system.

Monitoring and Evaluation by Grantee
Definitions/Abbreviations
USPSTF = United States Preventive Services Task Force
MIYO = “Make It Your Own” www.miyoworks.org
Research-tested messages and designs for health
communications materials

EMR = Electronic Medical Records
PN = Patient Navigation
CHWs = Community Health Workers

August 2017

CS250452-B

Provider Reminders for the NBCCEDP – Logic Model
EVIDENCE-BASED STRATEGY
ACTIVITIES

OUTPUTS

SHORT-TERM OUTCOMES

Identify and recruit partners
to implement provider
reminder systems

Appropriate partners recruited
to implement provider
reminder systems

Increased implementation of
provider reminder systems
among health systems/clinics
within grantee service area

Obtain annual rates of B&C
cancer screening

Accurate rates of B&C cancer
screening obtained according
to CDC guidance and reported
to CDC

Increased number of primary care
clinics with accurate B&C
cancer screening rates

Assess current records
management process and select
provider reminder method

Provider reminder method
selected consistent with
assessment findings

Improved provider knowledge
of and adherence to USPSTF B&C
cancer screening guidelines

Educate providers* on USPSTF
B&C cancer screening guidelines

Targeted providers educated
on USPSTF B&C cancer
screening guidelines

Implement provider reminder
system (e.g., flag medical charts,
adapt EMR system)

Increased provider
recommendations
for patients to
receive B&C
cancer screening
consistent with
guidelines

B&C cancer screening reminders
consistent with guidelines
delivered to primary
care providers

Increased
patient
completion
of B&C cancer
screening

INTERMEDIATE OUTCOMES

Moderating factors:
• Organizational barriers (e.g.,
limited IT or EMR system)

Moderating factors:
• Structural barriers (e.g., lack of
provider referral for screening)
• Patient barriers (e.g., fear, cost)
• Limited capacity for:
• Colposcopy
• Mammography

Increased health system/clinic
B&C cancer screening rates

The term “providers” refers to any/all clinical staff involved in implementation/use of the provider reminders.

Monitoring and Evaluation by Grantee
Definitions/Abbreviations
USPSTF = United States Preventive Services Task Force
MIYO = “Make It Your Own” www.miyoworks.org
Research-tested messages and designs for health
communications materials

EMR = Electronic Medical Records
PN = Patient Navigation
CHWs = Community Health Workers

August 2017

CS250452-B

Reducing Out of Pocket Costs for the NBCCEDP – Logic Model
EVIDENCE-BASED STRATEGY
ACTIVITIES

OUTPUTS

SHORT-TERM OUTCOMES

Identify and recruit partners to
reduce out of pocket costs

Appropriate partners recruited
to implement provider
reminder systems

Reduced out of pocket costs for
B&C cancer screening among
priority population

Obtain annual rates of B&C
cancer screening

Accurate rates of B&C cancer
screening obtained according
to CDC guidance and reported
to CDC

Increased number of primary care
clinics with accurate B&C
cancer screening rates

Identify priority population and
conduct assessment to identify
out of pocket costs impeding
access to B&C cancer screening

Priority population identified and
strategy to reduce out of pocket
costs selected consistent with
assessment findings (e.g. co-pay
reimbursement, voucher
for transportation, $ or
reimbursement for childcare)

Increased access to B&C cancer
screening for priority population

Implement at least one of the
following strategies:
• Reimburse clinical services/
co-pays
• Pay for/reimburse other
expenses incurred in order to
obtain screening (e.g., childcare,
parking, transportation)

Increased patient completion
of B&C cancer screening

INTERMEDIATE OUTCOMES

Moderating factors:
• Structural barriers (e.g., lack of
provider referral for screening)
• Patient barriers (e.g., fear, cost)
• Limited capacity for:
• Colposcopy
• Mammography
Increased health system/clinic
B&C cancer screening rates

Monitoring and Evaluation by Grantee
Definitions/Abbreviations
USPSTF = United States Preventive Services Task Force
MIYO = “Make It Your Own” www.miyoworks.org
Research-tested messages and designs for health
communications materials

EMR = Electronic Medical Records
PN = Patient Navigation
CHWs = Community Health Workers

August 2017

CS250452-B

Patient Reminders for the NBCCEDP – Logic Model
EVIDENCE-BASED STRATEGY
ACTIVITIES

OUTPUTS

SHORT-TERM OUTCOMES

Identify and recruit partners
to implement patient
reminder systems

Appropriate partners recruited
to implement patient
reminder systems

Increased implementation of
patient reminder systems among
health systems/clinics within
grantee service area

Obtain annual rates of B&C
cancer screening

Accurate rates of B&C cancer
screening obtained according
to CDC guidance and reported
to CDC

Increased number of primary care
clinics with accurate B&C
cancer screening rates

Assess current records
management process and select
patient reminder method

Patient reminder method selected
consistent with assessment
findings

Educate implementers* on
USPSTF B&C cancer
screening guidelines

Targeted implementers educated
on USPSTF B&C cancer
screening guidelines

Implement patient reminder
system (e.g., postcards, letters)

INTERMEDIATE OUTCOMES

Moderating factors:
• Organizational barriers (e.g.,
limited IT or EMR system)

Moderating factors:
• Structural barriers (e.g., lack of
provider referral for screening)
• Patient barriers (e.g., fear, cost)
• Limited capacity for:
• Colposcopy
• Mammography

Increased demand
for B&C screening
among priority
population

B&C cancer screening reminders
consistent with guidelines
delivered to patients

Increased
patient
completion
of B&C cancer
screening

Increased health system/clinic
B&C cancer screening rates

*The term ’implementers” refers to any/all staff involved in implementation/use of the patient reminder system.

Monitoring and Evaluation by Grantee
Definitions/Abbreviations
USPSTF = United States Preventive Services Task Force
MIYO = “Make It Your Own” www.miyoworks.org
Research-tested messages and designs for health
communications materials

EMR = Electronic Medical Records
PN = Patient Navigation
CHWs = Community Health Workers

August 2017

CS250452-B

Reducing Structural Barriers for the NBCCEDP – Logic Model
EVIDENCE-BASED STRATEGY
ACTIVITIES

OUTPUTS

SHORT-TERM OUTCOMES

Identify and recruit partners to
reduce structural barriers

Appropriate partners recruited to
reduce structural barriers

Reduced out of pocket costs for
B&C cancer screening among
priority population

Obtain annual rates of B&C
cancer screening

Accurate rates of B&C cancer
screening obtained according
to CDC guidance and reported
to CDC

Increased number of primary care
clinics with accurate B&C
cancer screening rates

Identify priority population and
conduct assessment to identify
out of pocket costs impeding
access to B&C cancer screening

Priority population identified and
strategy to reduce barriers
selected consistent with
assessment findings

Implement at least one of the
following strategies:
• Offer cancer screening services in
alternative/ non-clinical settings
• Reduce time or distance between
service delivery settings and
priority population
• Modify hours of service to meet
patient needs
• Eliminate or simplify
administrative procedures
• Eliminate or reduce obstacles
(e.g., dependent care,
transportation, language)

INTERMEDIATE OUTCOMES

Moderating factors:
• Structural barriers (e.g., lack of
provider referral for screening)
• Patient barriers (e.g., fear, cost)
• Limited capacity for:
• Colposcopy
• Mammography

Outputs dependent on strategy
selected (Example: “breast
cancer screening services offered
in alternative/non-clinical
settings appropriate for
priority population”)

Increased access to
B&C cancer screening for priority
population

Increased
patient
completion
of B&C cancer
screening

Increased health system/clinic
B&C cancer screening rates

Monitoring and Evaluation by Grantee
Definitions/Abbreviations
USPSTF = United States Preventive Services Task Force
MIYO = “Make It Your Own” www.miyoworks.org
Research-tested messages and designs for health
communications materials

EMR = Electronic Medical Records
PN = Patient Navigation
CHWs = Community Health Workers

August 2017

CS250452-B

Small Media for the NBCCEDP– Logic Model
EVIDENCE-BASED STRATEGY
ACTIVITIES

OUTPUTS

SHORT-TERM OUTCOMES

Identify and recruit partners to
implement small media

Appropriate partners recruited to
implement small media

Increased distribution of small
media within grantee service area

Obtain annual rates of B&C
cancer screening

Accurate rates of B&C cancer
screening obtained according
to CDC guidance and reported
to CDC

Increased number of primary care
clinics with accurate B&C
cancer screening rates

Identify priority population and
conduct assessment to inform
small media messaging and
distribution channels

Priority population identified,
small media messaging selected,
and distribution channels
specified consistent with
assessment findings

Improved knowledge about
B&C cancer screening among
priority population

Identify/customize small
media materials with tested
messages (MIYO)*

Distribute small media materials

Increased demand
for B&C cancer
screening among
priority population

Small media materials customized
for and delivered to individuals in
the priority population

Increased
patient
completion
of B&C cancer
screening

INTERMEDIATE OUTCOMES

Moderating factors:
• Structural barriers (e.g., lack of
provider referral for screening)
• Patient barriers (e.g., fear, cost)
• Limited capacity for:
• Colposcopy
• Mammography

Increased health system/clinic
B&C cancer screening rates

*CDC recommends use of scientifically tested messages (MIYO) or, if grantee is developing original materials, that adequate message testing be conducted.

Monitoring and Evaluation by Grantee
Definitions/Abbreviations
USPSTF = United States Preventive Services Task Force
MIYO = “Make It Your Own” www.miyoworks.org
Research-tested messages and designs for health
communications materials

EMR = Electronic Medical Records
PN = Patient Navigation
CHWs = Community Health Workers

August 2017

CS250452-B

Group Education for the NBCCEDP– Logic Model
EVIDENCE-BASED STRATEGY
ACTIVITIES

OUTPUTS

SHORT-TERM OUTCOMES

Identify and recruit partners to
implement group education

Appropriate partners recruited to
implement group education

Increased occurrence of group
education sessions within grantee
service area

Obtain annual rates of B&C
cancer screening

Accurate rates of B&C cancer
screening obtained according
to CDC guidance and reported
to CDC

Increased number of primary care
clinics with accurate B&C
cancer screening rates

Identify priority population
and conduct assessment to inform
content and format of
group education

Priority population identified,
group education content selected,
and format specified consistent
with assessment findings

Improved knowledge about
B&C cancer screening among
priority population

Identify/customize small
media materials

Individuals delivering Group
Education appropriately trained

Train individuals delivering
group education sessions
Conduct group education
sessions

Increased demand
for B&C cancer
screening among
priority population

Group education sessions
customized for and delivered to
priority population

Increased
patient
completion
of B&C cancer
screening

INTERMEDIATE OUTCOMES

Moderating factors:
• Structural barriers (e.g., lack of
provider referral for screening)
• Patient barriers (e.g., fear, cost)
• Limited capacity for:
• Colposcopy
• Mammography

Increased health system/clinic
B&C cancer screening rates

*See also logic model Small Media for the NBCCEDP.

Monitoring and Evaluation by Grantee
Definitions/Abbreviations
USPSTF = United States Preventive Services Task Force
MIYO = “Make It Your Own” www.miyoworks.org
Research-tested messages and designs for health
communications materials

EMR = Electronic Medical Records
PN = Patient Navigation
CHWs = Community Health Workers

August 2017

CS250452-B

One on One Education for the NBCCEDP– Logic Model
EVIDENCE-BASED STRATEGY
ACTIVITIES

OUTPUTS

Identify and recruit partners to
implement one on one education

Appropriate partners recruited
to implement one on
one education

Increased occurrence of one on
one education sessions within
grantee service area

Obtain annual rates of B&C
cancer screening

Accurate rates of B&C cancer
screening obtained according
to CDC guidance and reported
to CDC

Increased number of primary care
clinics with accurate B&C
cancer screening rates

Identify priority population and
conduct assessment to inform
content and format of one on
one education

Priority population identified,
one on one education content
selected, and format specified
consistent with assessment
findings

Improved knowledge about
B&C cancer screening among
priority population

Identify/customize small
media materials*
Train individuals delivering one
on one education sessions
Conduct one on one
education sessions

SHORT-TERM OUTCOMES

Individuals delivering one
on one education
appropriately trained
Increased demand
for B&C cancer
screening among
priority population

One on one education sessions
customized for and delivered to
priority population

Increased
patient
completion
of B&C cancer
screening

INTERMEDIATE OUTCOMES

Moderating factors:
• Structural barriers (e.g., lack of
provider referral for screening)
• Patient barriers (e.g., fear, cost)
• Limited capacity for:
• Colposcopy
• Mammography

Increased health system/clinic
B&C cancer screening rates

*See also logic model Small Media for the NBCCEDP.

Monitoring and Evaluation by Grantee
Definitions/Abbreviations
USPSTF = United States Preventive Services Task Force
MIYO = “Make It Your Own” www.miyoworks.org
Research-tested messages and designs for health
communications materials

EMR = Electronic Medical Records
PN = Patient Navigation
CHWs = Community Health Workers

August 2017

CS250452-B

Patient Navigation (PN) for the NBCCEDP – Logic Model
PROGRAM SUPPORTED ACTIVITY
ACTIVITIES

OUTPUTS

SHORT-TERM OUTCOMES

Identify and recruit partners to
implement PN

Appropriate partners recruited to
implement PN

Increased implementation of PN
programs among clinics/health
systems/other sites within grantee
service area

Obtain annual rates of B&C
cancer screening

Accurate rates of B&C cancer
screening obtained according
to CDC guidance and reported
to CDC

Train navigators on necessary
topics (e.g., PN role, cancer
screening)

Navigators appropriately trained

Navigator responsibilities:
• Enroll patients from priority
population in PN
• Assess patient barriers to B&C
cancer screening/diagnostics
• Provide culturally competent
health education and
social support**
• Facilitate resolution of
patient barriers
• Conduct patient tracking and
follow-up
• Ensure patients and primary care
providers receive screening/
diagnostics results
*NBCCEDP Policies Manual for PN Policy

INTERMEDIATE OUTCOMES

Increased number of primary care
clinics with accurate B&C cancer
screening rates
Increased access
to B&C cancer
screening for
priority
population

Barriers assessed and resolved for
priority population and individuals
within that population

Improved
knowledge of
B&C cancer
screening
among priority
population

Increased patient completion of
B&C cancer screening

Patients educated on B&C
cancer screening and/or
diagnostic procedures

Moderating factors:
• Structural barriers (e.g., lack of
provider referral for screening)
• Patient barriers (e.g., fear, cost)
• Limited capacity for:
• Colposcopy
• Mammography
Increased health system/clinic
B&C cancer screening rates

Increased patient understanding
of screening results and necessary
follow-up

Patients tracked effectively, timely
reminders delivered, and
screening results given to patients
and primary care providers in a
timely manner

Increased provision of screening
results and necessary follow-up to
primary care provider

**See also logic models for One on One and Group Education for the NBCCEDP

Monitoring and Evaluation by Grantee
Definitions/Abbreviations
USPSTF = United States Preventive Services Task Force
MIYO = “Make It Your Own” www.miyoworks.org
Research-tested messages and designs for health
communications materials

EMR = Electronic Medical Records
PN = Patient Navigation
CHWs = Community Health Workers

August 2017

CS250452-B

Community Outreach for the NBCCEDP – Logic Model
PROGRAM SUPPORTED ACTIVITY
ACTIVITIES

OUTPUTS

SHORT-TERM OUTCOMES

Identify and recruit partners for
linking community members
from the priority population to
partner clinics

Appropriate partners recruited

Increased implementation of PN
programs among clinics/health
systems/other sites within grantee
service area

Obtain annual rates of B&C
cancer screening

Accurate rates of B&C cancer
screening obtained according
to CDC guidance and reported
to CDC

Increased number of primary care
clinics with accurate B&C cancer
screening rates

Train staff responsible for
community outreach on relevant
topics (e.g., role, cancer screening)

CHWs and other staff responsible
for community outreach
appropriately trained

Outreach staff responsibilities:
• Identify priority population in
the community
• Provide culturally competent
health education and
social support*
• Help reduce participants’ barriers
to accessing clinical services
• Link/Connect participants to
partner clinics** for B&C
cancer screening
• Track participants from
community through
screening completion

Barriers assessed and resolved for
priority population and individuals
within that population

INTERMEDIATE OUTCOMES

Moderating factors:
• Structural barriers (e.g., lack of
provider referral for screening)
• Patient barriers (e.g., fear, cost)
• Limited capacity for:
• Colposcopy
• Mammography

Increased access to B&C cancer
screening for priority population
Increased knowledge of B&C
cancer screening among
priority population

Participants educated on B&C
cancer screening and/or
diagnostic procedures

Increased patient completion of
B&C cancer screening

Community members linked to
health system/clinics

Increased health system/clinic
B&C cancer screening rates

Participants tracked effectively
and timely reminders delivered

*See also logic models for One on One and Group Education for the NBCCEDP

**When possible, link patients to clinics where BCCEDP programs are in place

Monitoring and Evaluation by Grantee
Definitions/Abbreviations
USPSTF = United States Preventive Services Task Force
MIYO = “Make It Your Own” www.miyoworks.org
Research-tested messages and designs for health
communications materials

EMR = Electronic Medical Records
PN = Patient Navigation
CHWs = Community Health Workers

August 2017

CS250452-B