Development of an impact evaluation framework and planning tool for field epidemiology training programs

BACKGROUND:
Despite the growth and diversification of Field Epidemiology Training Programs (FETPs) globally, there are few published evaluations. Those that have been published largely focus on program processes and outputs, with some including short-medium-term outcomes and very few focusing on sustained impact. This paper describes the process of developing an FETP impact evaluation framework and FETP impact evaluation planning tool to facilitate FETP impact evaluations. The impact framework was developed to be simple, flexible and efficient.

METHODS:
A theory of change process for an FETP in Papua New Guinea formed the basis of the impact evaluation framework. With support from independent impact evaluation experts, the framework was developed using an iterative approach. A review of the literature and technical input from FETP representatives underpinned its development. A simple planning tool was developed to help operationalise the impact framework.

RESULTS:
The final FETP impact evaluation framework consists of a high-level summary framework and a detailed operational framework. The high-level framework follows the flow of outputs, outcomes and impacts for trainees, graduates, the public health systems, and communities. The detailed FETP Impact Evaluation Framework includes activities, enablers and barriers, and output, outcome and impact indicators. The FETP Impact Evaluation Planning Tool consists of five steps using a theory-based approach.

CONCLUSIONS:
The long history and global growth of the FETP model suggest success and imply impact, yet few published papers provide necessary backing evidence. There is growing interest across the FETP community and funders to understand the longer-term changes that FETPs contribute to. We developed an impact framework and planning tool specifically designed to support FETP impact evaluation. The framework and tool are intended to be used by FETP staff with no prior evaluation experience. The evaluation approach is intentionally flexible, allowing contextual application and integration with established quantitative and qualitative evaluation methods.