HLTH 5483 Module 4 Evaluation Data Analysis Example

What the First Twelve Weeks Showed: Analyzing Process and Outcome Data From a Senior Center Tai Chi Pilot and Drawing Justified Conclusions

Student Name

American College of Education

HLTH5483: Health and Wellness Program Assessment and Evaluation

Module 4 Assignment

Instructor Name

October 26, 2026

Introduction

The evaluation designed in Module 3 has now produced data from the first 12-week session of the tai chi pilot at two senior centers in a composite county. This paper analyzes those data. It reports process findings on reach, fidelity, attendance and dropout, then outcome findings on confidence, pain, lower-body strength and physical activity, compared with members at a third center that will receive the program next year. It interprets what the findings mean, identifies their limits and recommends changes before the second session. Justifying conclusions, the fifth step of the CDC framework, means linking each conclusion to evidence and to standards agreed with stakeholders (Centers for Disease Control and Prevention [CDC], 1999). The figures reported here are the program's own composite data.

Reach

Fifty-eight members enrolled, just short of the target of 60. Compared with members with arthritis identified in the needs assessment, the program reached women well (71% of participants, similar to the membership) and Spanish-speaking members reasonably well (12 participants, 21%, most through the Spanish-language class). It reached members aged 75 and older less well: they made up 34% of participants but about 45% of members with arthritis. Men were somewhat underrepresented at 29%. Twenty-three participants, 40%, used the transportation service at least once, suggesting that rides were important for access. Nineteen participants came through clinician referrals, showing that outreach to physicians worked.

Fidelity, Attendance and Dropout

Of 48 scheduled classes across the two centers, 46 were held; two were canceled for snow. The coordinator's fidelity checklist, completed at every fourth class, found that instructors delivered all core elements in 92% of observed classes; the most common omission was the closing discussion when classes ran long. Average attendance among those who completed the program was 74% of classes, above the target of 70%. Nine participants, 16%, dropped out. Phone calls found that four left because of other health problems, two because of family caregiving demands, two because the class time conflicted with other activities and one because of knee discomfort that the instructor had not modified sufficiently. Dropouts were somewhat older on average than completers, and five of the nine were 75 or older.

Outcome Findings

Forty-nine participants and 41 comparison members completed measures at baseline and week 12. Arthritis self-efficacy, measured with the scale developed by Lorig et al. (1989) and scored from 1 to 10, rose on average from 5.2 to 6.5 in the program group, compared with 5.4 to 5.6 in the comparison group. Scores on the osteoarthritis pain and stiffness questionnaire fell by an average of 27% in the program group and 6% in the comparison group. On the 30-second chair stand, a test that Jones et al. (1999) showed to be dependable for gauging leg strength in people living independently in later life, the program group improved from an average of 9.1 to 11.3 stands, while the comparison group changed from 9.4 to 9.7. Moderate-intensity activity reported on the CHAMPS questionnaire rose by an average of 70 minutes a week in the program group and 12 minutes in the comparison group.

The differences between groups in change were consistently in favor of the program, and the confidence intervals for the differences in self-efficacy, pain and chair stand change excluded zero. The activity difference was less precise, with a wide interval, reflecting the variability of self-reported activity. Six-month follow-up has not yet been completed.

Interpretation

The findings suggest that the program produced meaningful short-term improvements in the outcomes the logic model predicted. Gains in confidence came alongside less pain and more strength, which fits the theory of change: adapted movements that participants can perform without pain build their belief that exercise is safe, and that belief supports steady practice. The direction of the pain results also matches the clinical evidence. The knee osteoarthritis trial by Wang et al. (2016) compared tai chi with physical therapy under research conditions and found the two roughly equal in effect; seeing improvement of the same kind in a senior center, with community instructors and a more varied group of participants, lends support to the logic model's assumption that the trial's results would carry over. The rise in weekly activity is encouraging but less certain, because it rests on participants' own reports.

Limitations

Several limitations temper these conclusions. Participants chose to enroll, and they may have been more motivated than comparison members, even though baseline scores were similar. The comparison center differs in neighborhood and membership. Participants knew they were in the program, which may have influenced self-reported pain and activity. Nine participants dropped out, and because dropouts were older, results may overstate benefits for the oldest members. The sample is small, so estimates are imprecise and subgroup results cannot be trusted. Finally, 12-week results do not show whether gains last; the six-month follow-up will address that question.

Stakeholder Review of the Findings

Before conclusions were finalized, the health educator presented the results to the stakeholder group that had helped design the evaluation: both center directors, the two instructors, four participants, the physical therapist and a representative of the department of aging. The review changed the interpretation in useful ways. Participants explained that the pain improvements felt real in daily life, such as easier walking from the parking lot, which supported the questionnaire results. The instructors pointed out that the one dropout related to knee discomfort occurred in a week when a substitute taught, suggesting a training gap rather than a problem with the program itself. The directors noted that the comparison center had a flu outbreak in the ninth week, which might have lowered its members' activity and exaggerated the difference in activity change; the group agreed to describe the activity result more cautiously as a result. The department representative asked for cost per participant, which the evaluator added to the full report. Involving stakeholders at this stage made the conclusions more accurate and increased their confidence in them.

Conclusions and Recommendations

The evidence supports a cautious conclusion: in its first session, the pilot reached most intended groups, was delivered largely as designed and was followed by improvements in confidence, pain, strength and likely activity that exceeded changes at the comparison center. Based on these findings and stakeholder discussion, the evaluation recommends continuing the program for a second session with five changes. First, strengthen outreach to members aged 75 and older and to men, for example through personal invitations at meals and a class promoted by male members. Second, schedule classes at times that avoid conflicts identified by dropouts. Third, add a brief instructor refresher on modifying movements for knee discomfort. Fourth, shorten the teaching portion slightly so the closing discussion is not skipped. Fifth, complete the six-month follow-up before deciding on expansion to the other three centers.

Sharing the Findings

Results will be shared in forms suited to each audience. Participants will receive a one-page summary in English and Spanish with charts showing group changes and a thank-you. Center directors and instructors will review a slightly longer report with process findings and recommendations. The department of aging and funders will receive a full report with methods, results, limitations and recommendations. Referring clinicians will receive a short letter describing the program's results and inviting further referrals. Sharing findings in usable forms completes the cycle described in the CDC framework and supports decisions about the program's future.

References

Centers for Disease Control and Prevention. (1999). Framework for program evaluation in public health. MMWR Recommendations and Reports, 48(RR-11), 1-40.

Jones, C. J., Rikli, R. E., & Beam, W. C. (1999). A 30-s chair-stand test as a measure of lower body strength in community-residing older adults. Research Quarterly for Exercise and Sport, 70(2), 113-119. https://doi.org/10.1080/02701367.1999.10608028

Lorig, K., Chastain, R. L., Ung, E., Shoor, S., & Holman, H. R. (1989). Development and evaluation of a scale to measure perceived self-efficacy in people with arthritis. Arthritis & Rheumatism, 32(1), 37-44. https://doi.org/10.1002/anr.1780320107

Wang, C., Schmid, C. H., Iversen, M. D., Harvey, W. F., Fielding, R. A., Driban, J. B., Price, L. L., Wong, J. B., Reid, K. F., Rones, R., & McAlindon, T. (2016). Comparative effectiveness of tai chi versus physical therapy for knee osteoarthritis: A randomized trial. Annals of Internal Medicine, 165(2), 77-86. https://doi.org/10.7326/M15-2143