Form 0920-24FI In-Depth Assessment – Evaluability Assessment Recipient

Form Approved

OMB No. 0920-XXXX

Exp. Date xx/xx/20xx

In-Depth Assessment – Evaluability Assessment Recipient Interview Guide – Clinical Quality Measure – WISEWOMAN

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Evaluability Assessment

Recipient Interview Guide

Date of Interview
Interviewer
Notetaker
Organization Name
Organization Type
State
Organization City		Zip Code
Cooperative Agreement	​☐​ WISEWOMAN
Strategy	Strategy 1: Track and Monitor Clinical Measures
Interviewee Name(s)
Interviewee Role(s) or Title(s)

Introduction

Thank you for taking the time to participate in this interview. My name is <Insert name> and I am with the Deloitte evaluation team. Our team is working with the CDC Division for Heart Disease and Stroke Prevention to evaluate the Well-Integrated Screening and Evaluation of WOMen Across the Nation (WISEWOMAN) program. As part of the CDC-led evaluation, we are conducting evaluability assessment interviews to provide detailed insight into how recipients are prioritizing populations of focus impacted by the high prevalence of cardiovascular disease through Strategy 1: Track and Monitor Clinical Measures. We hope to learn about the function, structure, goals, and activities of your program in today’s discussion. Additionally, the evaluability assessment will be used to identify recipients with promising approaches, who will be invited to participate in an exploratory assessment during PY4.

Our team has drafted a logic model based on program materials that your team shared with us prior to this interview. We may refer to the draft logic model throughout the interview to facilitate discussion on program goals, activities, desired outcomes, and contextual factors.

This interview is expected to take no longer than 90 minutes. Please answer questions based on your own knowledge and experience. Remember, you are the expert and that there are no right or wrong answers. If at any time during the interview you are not clear about what we are asking, be sure to let me know. Your participation in this interview is completely voluntary. You may choose not to respond to questions at any time and it will not in any way impact the funding or technical assistance your organizations receive from CDC.

Steps will be taken to protect your privacy; no information that identifies you will be shared with anyone except our project staff. All information will be kept secure and any personally identifiable information will be removed when results are aggregated for analysis.

Do you consent to this interview?

☐ Yes

☐ No

With your permission, we would like to record this interview for transcription purposes. 

Do we have your permission to record?

​​☐​ Yes 

​​☐​ No 

 

Do you have any questions or concerns before we start the discussion? 

Background

Thank you again for participating in this interview. For reference, today’s interview we will be talking about Strategy 1, which is defined as:

Track and monitor clinical measures shown to improve health and wellness, health care quality, and identify patients at risk of and with CVD, particularly hypertension.

We will discuss the following sub-strategies under Strategy 1:

[Interviewer Note: Only describe the relevant sub-strategies for which the recipient organization has self-nominated]

1A: Provide cardiovascular disease (CVD) risk assessment to under- and uninsured participants in the priority age range of 35- 64 years during the baseline, follow-up, and reassessment office visits, as appropriate.

1B: Use electronic health record (EHR) and health information technology (HIT) data to query, monitor, and track clinical and social services and support needs data for improved identification, management, referrals, treatment, and outcomes of those at risk of CVD, particularly hypertension.

1C: Use standardized procedures to identify social services and support needs of participants and monitor and assess the referral and utilization of those services, such as food assistance, transportation, housing, childcare, etc.

1D: Use metrics from program data to guide quality improvement activities, e.g., Plan Do Study Act (PDSA) cycles, participant and partner feedback, etc., to increase program enrollment, retention, and referrals to additional services.

1E: Use EHR, HIT or program data to identify health care disparities and address health outcomes within their WISEWOMAN population.

First, we would like to learn a little about you and your organization.

[Interviewer Note: Use the following question to confirm information learned from the nomination form and document review about interviewee’s organization.]

1. From the <nomination form, APR, work plan, EPMP, etc.>, we learned that your organization offers <programs and services> for <population >. Is this correct? Is there anything else you would like to add or clarify?

Probes:

• What types of services/programs, related to WISEWOMAN, does your organization offer?

• How long has your organization been offering these services/implementing these programs?

• Can you describe to me the different populations (i.e., race, ethnicity, socioeconomic status, age, etc.) that your organization typically serves or focuses on?

[Interviewer Note: Use the following question to understand the interviewee’s role related to the nominated strategy/sub-strategies. Tailor the strategy-related language based on how the interviewee(s) describe the sub-strategy/sub-strategies.]

2. What is/are your role(s) and what are your specific responsibilities related to WISEWOMAN?

Probes:

• How long have you been working with <organization name>?

• How long have you been in this role?

• Can you tell me about your role in relation to supporting the < EHRs/HIT activities, implementation of clinical measures, CVD risk assessments, use of program data to guide quality improvement, use standardized procedures to identify social needs>?

Program Implementation

[Interviewer Note: Ask about each nominated sub-strategy for the Program Implementation questions.]

Next, we would like to discuss your organization’s approach to address Strategy 1: Track and Monitor Clinical Measures or CQM. We’re interested in learning more about the program goals, key activities, implementation strategy, and intended program reach.

[Interviewer Note: Use the following question to understand the implementation of the nominated strategy/sub-strategies. Confirm what we’ve learned from the document review and nomination form. Tailor the language based on how recipient refers to their program and activities rather than using NOFO specific language]

3. According to the <organization’s program materials, recipient-led evaluation deliverables, nomination form>, your program approach related to <EHRs/HIT and CQM> is <description of program. > Can you tell us more about the key activities and core components of <program name>? Describe things like the types of interventions being implemented, how it is implemented, and in what settings.

Probes:

• Where is the program implemented?

• What EHR systems do your partner organizations use?

• 1A: What program activities are being implemented to increase the number of CVD risk assessments to under- and uninsured participants between ages 35- 64 years?

• 1B: How does your program approach increase the use of EHRs/HIT to query, track, and monitor measures for clinical and social services?

  • What are the steps involved?

• How is data on clinical and social services measures used to:

  • 1D: Guide quality improvement efforts?

• 1C: What interventions improve the identification of social services and support needs?

  • What standardized processes or tools are used? How do they support patient identification?

• 1C: What program activities promote the monitoring and assessment of referrals and utilization of social services?

  • What is the protocol for monitoring referrals and utilization?

  • What standardized processes or tools are used?

  • How is referral and utilization (i.e., referral enrollment and completion) data used to:

    • 1D: Guide quality improvement efforts?

• 1D: Describe the quality improvement activities (e.g., PDSA cycles) being implemented to increase program enrollment, retention, and referrals to services.

[Interviewer Note: Ask the following questions if the recipient stated in the nomination form that they are working on cardiac rehab or hypertension among pregnant or postpartum people.]

4. According to the < nomination form>, we learned that you are implementing <cardiac rehab and/or activities related to hypertension in pregnant or postpartum people.> Can you tell us more about these activities?

Probes:

• [If applicable based on recipient response in the nomination form] Tell me more about your cardiac rehab programming. What types of activities are implemented?

• [If applicable based on recipient response in the nomination form] What types of intervention activities prioritize or focus on pregnant or postpartum people? How do you tailor your activities for pregnancy and postpartum period?

5. What partnerships are in place to support <CQM strategy/sub-strategy implementation>?

Probes:

• What types of organizations are you partnering with and in what ways do they implement the program or support <CQM>?

• Tell me more about how you collaborate with your partners.

• How do you support your partners implement their <EHR/HIT and CQM activities>?

• What has worked well and what hasn’t worked as well with your partner health systems or clinics?

1. What are the goals of the <program name related to strategy> and how will the <program> achieve these goals?

Probe:

• What do you hope to achieve through quality improvement and CQM-related activities?

7. What is the <program’s> population of focus?

Probes:

• How do you define the population of focus? What demographics, patient characteristics, or geographies are you prioritizing?

• How did you identify your population of focus? What data and methods do you use?

• What tools and resources have you used to understand or identify the health disparities in your population of focus?

• What barriers do the population of focus face in terms of management and treatment of CVD? How do SDOH factors affect their CVD risk?

8. How do your <EHRs/HIT activities> address health disparities related to hypertension?

Probes:

• How are quality improvement efforts tailored to the needs of your population of focus?

• How do EHR/HIT activities address the needs of your population?

• 1A: How does SDOH affect the patient uptake of CVD risk assessments? How does this affect your program approach?

• 1E: How are data extracted from EHR/HIT used to advance health equity and improve health outcomes?

Now that we’ve learned more about your program approach from its goals and operations, we would like to learn more about the extent of program implementation, successes and challenges with implementation, and factors that may support or hinder activities.

9. Tell us more about your progress related to <name of program> and <EHRs/HIT and CQM activities>?

Probe:

• Tell us more about milestones and other achievements.

• What are some areas where you did not make as much progress as anticipated?

1. What are your future implementation plans?

Probes:

• How will your partnerships change or grow in the next few years?

• Please describe what you hope to accomplish by Year 4 (September 2026 – September 2027).

11. Can you tell us about the contextual factors that support or hinder <activities related to tracking and monitoring clinical measures>?

Probes:

• Describe external factors such as complementing or competing initiatives, additional funding sources, partnerships and collaborations, state policies, political/economic climate.

• Describe internal factors such as organizational policies, leadership buy-in, internal capacity, organizational culture.

12. What would you say are the strengths of your <program>?

Probe:

• What factors positively affect <CQM strategy/sub-strategy implementation> or helped the program be successful?

13. What challenges have you experienced with <CQM strategy/sub-strategy implementation>?

Probes:

• How are these challenges addressed?

• What additional support, resources, or TA do you need to overcome these barriers?

14. What have been some key lessons learned from your experience with <CQM strategy/sub-strategy implementation>?

[Interviewer Note: Only ask the next set of questions if the recipient organization participates in more than one NOFO. Otherwise, move on to the Program Evaluation section.]

Next, we’re interested in learning more about your organization’s involvement in other DHDSP cooperative agreement programs or how your organization may coordinate with other recipient organizations.

15. What other DHDSP cooperative agreements do you receive funding from? For example, The National CVH Program and The Innovative CVH Program.>

16. Do you coordinate with other recipient organizations that receive funding from DHDSP cooperative agreements?

17. How are you coordinating across <NOFO name(s)> to maximize resources and avoid duplication of effort?

Probes:

• How does your organization leverage funding across NOFOs?

• How does your organization leverage partnerships across NOFOs?

• How has your organization coordinated resources for shared impact across NOFOs?

18. What are the advantages of participating in and/or coordinating with multiple NOFOs?

19. What are the challenges with participating in and/or coordinating with multiple NOFOs?

Program Evaluation

[Interviewer Note: Ask about each nominated sub-strategy in the Program Evaluation questions.]

We would like to understand to what extent the <EHR/HIT and CQM activities> have been or are currently being evaluated. We are also interested in learning about your organization’s capacity to evaluate <program activities>.

1. Who is primarily responsible for tracking and reporting data related to <CQM implementation> for the WISEWOMAN program?

Probes:

• What is your role in data collection and monitoring and evaluation efforts?

• Are other members or organizations involved in data collection? Describe their roles and responsibilities.

2. What data are collected to help monitor <program activities> and evaluate its success?

Probes:

• What types of metrics or indicators do you use to measure progress and monitor implementation?

  • [If the interviewee only mentions PMs] What about metrics other than the NOFO performance measures?

  • [If the interviewee only mentions MDEs] What about metrics other than the MDE data?

• How is success measured?

• What outcomes do you track? What outcomes do you expect to have by Y4 (September 2026 – September 2027)?

  • [If the interviewee only mentions PMs] What about outcomes beyond the NOFO performance measures?

  • [If the interviewee only mentions MDEs] What about outcomes other than the MDE data?

3. How does <name of recipient organization> collect the data needed for monitoring and evaluation of <CQM>?

Probes:

• What data collection tools or instruments are used to track data (paper, electronic)?

  • [If not already provided] Request to see and get copies of data, data collection tools, or evaluation reports.

• Describe the process used to collect data.

• Describe how data are used.

• Do you collect data at specified points over time (time series)? What length of time? How frequently?

4. How is health equity incorporated in your evaluation plan?

Probes:

• What SDOH data do you collect?

• How will health disparities be measured and defined?

• What sort of methods or tools are used to measure health equity outcomes?

5. What, if any, barriers have you encountered with data collection or monitoring and evaluation activities?

Probes:

• What challenges, if any, are there with collecting SDOH data?

• What barriers, if any, do you anticipate in data collection or reporting related to outcome or impact?

• What specific strategies have been used or will be used to overcome these barriers?

• What additional support or TA do you need from CDC?

• What have been some lessons learned from your experience with data collection and evaluation related to Strategy 1: Track and Monitor Clinical Measures for the WISEWOMAN program?

6. What have you learned so far about your <CQM activities> from your monitoring and evaluation efforts?

Probes:

• What findings can you share about implementation progress?

• What outcomes can you report at this point?

• How are data being used to make improvements?

7. What is the timeline for the next phase of evaluation?

Probes:

• What are key events for data collection and evaluation?

• Are there anticipated barriers for the next phase?

8. Do you provide evaluation results related to <CQM implementation> to external audiences such as funders, partners, decision makers, constituents, or others?

Probes:

• What types of findings do you share? How do you share your findings?

• Do they use any of the information you provide? In what sorts of ways?

9. If <name of recipient> is selected to participate in an exploratory assessment of your program, to what extent would <name of recipient> have the capacity to contribute to detailed data collection on outcomes and/or cost?

Probes:

• What kind of assistance do you think you would need?

• Are there any other important considerations we should know about your readiness/capacity to participate in an evaluation?

Closing

Lastly, what questions do you have for me? Is there anything else you’d like to share?

Thank you again for participating. This concludes our discussion about CQM implementations. If you have any additional questions, please feel free to contact the Comprehensive Evaluation Team, [email protected].