The challenge of setting measurable outcomes
One of the difficulties in setting outcomes is that we often set targets that are unreasonable to expect from the intervention.
An example of this can be seen in studies dealing with sexual health promotion, as the sexual health lead from NICE explained when discussing the evidence in this area.
Evaluated sexual health projects often set the outcome they wanted to measure for a workshop as 'changing sexual behaviour'. It is difficult to know what would be needed to change sexual behaviour in anyone, but it is extremely unlikely that a two-hour workshop would do this, or be designed to do this.
So, the evaluations judged that workshops failed to change behaviour and could not be recommended as they had not achieved the outcomes they set out to deliver.
The evaluators did not collect information on whether the workshops improved knowledge and skills, which is usually what they are designed to do.
So it was impossible to know if the workshops were of a good quality for what they had been designed for.
The other problem is defining the outcome in sufficient detail so that you can collect evidence to show that there has been a change.
One of the most common outcomes we see in mental health advocacy is that clients will be 'more empowered' as a result of the advocacy.
One of our partners spent some time with the project advocates identifying what specific behaviours would indicate greater confidence in dealing with other services, for example, the client making a phone call independently (where the advocate had done this in the past).
The advocate noted these changes to see if their theory about advocacy being empowering was reasonable.
So, when setting outcomes, keep these thoughts in mind:
- ensure you can link the outcomes to the mechanism – is it reasonable to expect these changes (outcomes) from the intervention?
- specify changes (outcomes) that are observable – what will you see as a result of your work?
