Abstract
Objectives: Sustainability is a highly desired outcome of health promotion programs, yet it often eludes program planners looking to achieve it. This study aimed to uncover how the goal of program sustainability was interpreted by key stakeholders from three fall prevention program demonstration sites.
Method: Collected as part of a larger study on program sustainability that made use of a multiple case study methodology, semi-structured interviews were conducted with key informants involved in a wide range of program initiatives throughout the two-year funding period.
Results: Forty participants across the three sites provided definitions of sustainability. Most stakeholders reported that it was some version of the general fall prevention program that should be sustained. Fewer stakeholders reported that it was the successful elements or solutions to the program goals that should be sustained. The most common suggestions reported by stakeholders for how sustainability should be achieved were awareness raising and securing new funding sources. Although a number of key elements emerged, there were significant differences in stakeholders’ definitions of sustainability, both within and between demonstration sites.
Conclusion: This research provided insight into the unique meanings of sustainability held by different stakeholders during their involvement in a fall prevention program. The array of definitions held by stakeholders demonstrates how easily the efforts of those involved can become fragmented and, therefore, less effective in reaching the end goal of program sustainability when the project team is not working from the same definition of what that goal means.
Résumé
Objectifs: La durabilité est un résultat fort souhaité des programmes de promotion de la santé; pourtant, il échappe souvent aux planificateurs de programme qui cherchent à l’atteindre. Cette étude vise à découvrir comment l’objectif qu’est la durabilité d’un programme est interprété par les intervenants clés de trois sites de démonstration de programmes de prévention des chutes.
Méthode: Nous avons mené des entrevues semi-structurées auprès d’intervenants clés participant à un large éventail d’initiatives de programme dans le cadre d’une plus grande étude sur la durabilité des programmes, laquelle s’appuyait sur la méthodologie utilisée pour l’étude de cas multiples, sur une période de financement de deux ans.
Résultats: Au total, 40 participants provenant des trois sites ont présenté des définitions de ce qu’est la durabilité. La plupart des intervenants ont signalé qu’il fallait conserver une version du programme général de prévention des chutes. Quelques intervenants ont signalé qu’il fallait conserver les bons éléments ou les solutions aux objectifs du programme. Les suggestions les plus communes présentées par les intervenants concernant la façon d’atteindre la durabilité étaient la sensibilisation accrue et l’obtention de nouvelles sources de financement. Même si un grand nombre d’éléments clés ont été soulevés, nous avons observé d’importantes différences dans les définitions de la durabilité présentées par les intervenants, tant à l’intérieur des sites de démonstration qu’entre ceux-ci.
Conclusion: Cette recherche donne des éclaircissements sur les significations uniques de la durabilité aux yeux des différents intervenants dans le cadre de leur participation à un programme de prévention des chutes. L’éventail de définitions fournies par les intervenants démontre la mesure dans laquelle les efforts de ces personnes peuvent être fragmentés et, par conséquent, moins efficaces en ce qui a trait à l’atteinte de l’objectif final que représente la durabilité du programme si l’équipe de projet ne travaille pas en respectant la même définition que celle de l’objectif.
Similar content being viewed by others
References
Glasgow RE, Vogt TM, Boles SM. Evaluating the public health impact of health promotion interventions: The RE-AIM framework. Am J Public Health 1999;89(9):1322–27.
Steckler A, Goodman RM. How to institutionalize health promotion programs. Am J Health Promot 1989;3(4):34–44.
Nilsen P, Timpka T, Nordenfelt L, Lindqvist K. Towards improved understanding of injury prevention program sustainability. Saf Sci 2005;43:815–33.
Alexander JA, Weiner BJ, Metzger ME, Shortell SM, Bazzoli GJ, Hasnain-Wynia R, et al. Sustainability of collaborative capacity in community health partnerships. Med Care Res Rev 2003;60(4):130S-60S.
Crisp BR, Swerissen H, Duckett SJ. Four approaches to capacity building in health: Consequences for measurement and accountability. Health Promot Int 2000;15(2):99–107.
Pluye P, Potvin L, Denis J-L, Pelletier J, Mannoni C. Program sustainability begins with the first events. Eval Program Plann 2005;28:123–37.
Bracht N, Finnegan J, Jr., Rissel C, Weisbrod R, Gleason J, Corbett J, et al. Community ownership and program continuation following a health demonstration project. Health Educ Res 1994;9(2):243–55.
Livet M, Wandersman A. Organizational functioning: Facilitating effective interventions and increasing the odds of programming success. In: Fetterman DM, Wandersman A (Eds.), Empowerment Evaluation Principles in Practice. New York, NY: The Guilford Press, 2005;123–54.
Shediac-Rizkallah MC, Bone LR. Planning for community-based health programs: Conceptual frameworks and future directions for research, practice and policy. Health Educ Res 1998;13(1):87–108.
Scheirer MA. Is sustainability possible? A review and commentary on empirical studies of program sustainability. Am J Evaluation 2005;26(3):320–47.
Pluye P, Potvin L, Denis J-L. Making public health programs last: Conceptualizing sustainability. Eval Program Plann 2004;27:121–33.
Yin RK. Case Study Research: Design and Methods. Thousand Oaks, CA: Sage Publications, 2003.
Garner E, Kempton A, van Beurden E. Strategies to prevent falls: The Stay on Your Feet program. Health Promot J Austr 1996;6:37–43.
QSR International. NVivo 7 (Version 7). Australia: QSR International Pty Ltd., 2006.
Brown DR. Evaluating institutional sustainability in development programmes: Beyond dollars and cents. J Int Dev 1998;10(1):55–69.
O’Loughlin J, Renaud L, Richard L, Sanchez Gomez L, Paradis G. Correlates of the sustainability of community-based heart health promotion interventions. Prev Med 1998;27:702–12.
Olsen IT. Sustainability of health care: A framework for analysis. Health Policy Plan 1998;13(3):287–95.
Evashwick C, Ory M. Organizational characteristics of successful innovative health care programs sustained over time. Fam Community Health 2003;26(3):177–93.
Mancini JA, Marek LI. Sustaining community-based programs for families: Conceptualization and measurement. Family Relat 2004;53(4):339–47.
Humphreys JS, Wakerman J, Wells R. What do we mean by sustainable rural health services? Implications for rural health research. Aust J Rural Health 2006;14:33–35.
Author information
Authors and Affiliations
Corresponding author
Additional information
Acknowledgement: This research was completed with the support of a grant from the Ontario Neurotrauma Foundation.
Rights and permissions
About this article
Cite this article
Hanson, H.M., Salmoni, A.W. & Volpe, R. Defining Program Sustainability: Differing Views of Stakeholders. Can J Public Health 100, 304–309 (2009). https://doi.org/10.1007/BF03403952
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/BF03403952