Resource Guide: Remote Delivery of Evidence-based Programs

Phil Faris

In March 2020, providers of evidence-based health promotion programs canceled in-person classes in response to the COVID-19 pandemic. While some evidence-based programs were ready to be implemented immediately via the telephone or a video-conferencing platform, others required examination through pilot testing to determine feasibility in the new remote delivery format. This resource guide compiles best practices, whether you are just starting out to offer programs remotely or looking for ways to refining what you are already doing at your organization.

We will continue to update this information as changes occur and more information becomes available. If you have something to recommend for inclusion in the guide that could benefit the aging network and community-based organizations, please send the information for consideration to cha@ncoa.org.

Before Starting a Remote Evidence-Based Program

Choosing the right program(s) and technology

Remote implementation is possible for some evidence-based programs and not for others. The Center for Healthy Aging is in contact with the program developers to determine if programs can be delivered remotely, and if so, how it can be done with fidelity. To find the most up-to-date guidance on program delivery, please visit our webpage: Track Health Promotion Program Guidance During COVID-19. More information can also be found on each program developer’s website.

Once you determine if the programs you are currently providing can be implemented remotely, it will be important to decide on which tool(s) you will use to reach your audience. The Tools for Reaching a Remote Audience resource offers an overview, pros, cons, and costs for a variety of communication platforms.

Grand Rounds Presentations on this topic:

Leader Engagement: Opportunities and Challenges

Some programs do not require additional training for leaders to move to remote delivery. However, other programs require additional training or updates for Master Trainers and leaders. For more information on training requirements, please visit: Track Health Promotion Program Guidance During COVID-19.

Transitioning to remote classes is an adjustment for participants and leaders, too. Using a video-conferencing platform or delivering a program over the phone requires different skills that are not necessarily needed for in-person program delivery. You should consider providing a tutorial or training for leaders on how to deliver remote programming. Good examples of such training materials have been developed by the Michigan State University Extension and Technology Support Guide from the Western New York Integrated Care Collaborative.

A common best practice is to have an extra instructor available to help with technology or safety issues during each class. Other best practices include hosting a zero session and connecting with each participant before the start of the first class so participants can meet the instructor, complete any necessary paperwork, and become acquainted with the technology.

One opportunity to monitor progress of new and existing leaders is to use an action plan with useful tips and ideas for addressing unexpected events during class, see examples here:

One challenge many organizations are facing is keeping leaders engaged who do not feel comfortable leading virtual classes or have other commitments at this time.

Depending on the other services provided by your organization, you could have dedicated evidence-based program volunteers help with:

  • Making friendly phone calls – MAC COVID-19 Call Script
  • Recruiting for virtual evidence-based programs
  • Serving as technology helpers or safety monitors during physical activity programs

Marketing Remote Programming

While some marketing techniques for remote programming might be similar to marketing for in-person delivery, here are some examples for how to introduce your program to existing and new participants.

Without location restrictions, your organization may also have the opportunity reach new populations and participants such as homebound individuals or older adults who do not live near a program implementation site. Be sure to check with the program developer and license holder for guidelines about how many people from outside your designated area can attend your remote program.

During the Delivery of Remote Programming

Helping Older Adults with Technology

The COVID-19 pandemic has increased the number of older adults interacting with technology from everyday tasks such as ordering groceries online to interacting with family members over video-chat platforms. However, there are still older adults who need assistance connecting to the technology used for evidence-based programs.

To help older adults feel more comfortable using technology for classes and workshops it can be helpful to create a guide. See some examples here:

If your organization is looking for resources to connect older adults to technology and internet services, information can be found in NCOA’s FAQ: COVID-19 and Technology Resources.

If you are planning to loan technology devices to participants, many organizations have developed a process for checking in and out technology. Some examples are illustrated by this iPad Check-Out form from SDSU Extension’s Better Choices, Better Health and this Acceptable Use Agreement and Tablet Agreement from MAC, Inc.

For participants who want to further their learning about technology, here are some other resources:

What You Need to Know About Data Collection

Below are common data questions and answers for delivering programs remotely for ACL CDSME and Falls Prevention grantees.

Will programs implemented remotely count toward ACL CDSME and falls prevention grant participant reach and completer goals?

  • Participant reach: Any program approved to be implemented remotely (tracked here) will count towards grant participant reach goals. To be counted, participants must have an attendance record of attending at least one remote session (e.g., one class).
  • Completer reach: For ACL grants, a completer is an individual who attended at least 2/3rds of the sessions in a particular program, excluding any Session Zero classes. For example, 4 out of 6 sessions. Participants will be counted as a “completer” if they met this threshold, even if the workshop is delivered virtually or the entire workshop was not delivered.
  • Note for the CDSME Toolkit + Phone Calls: Participants that complete 4 out of the 6 phone calls will be considered a completer.

Do we need to collect attendance data for workshops implemented remotely?

Yes. For participants to count towards your grant goals, they must have a record of having attended at least one workshop session. We recommend program leaders use the standard OMB-approved attendance form to collect attendance data. The falls prevention program attendance log is available here and the CDSME attendance log is available here.

We would like to track which workshops have been impacted by the COVID-19 pandemic, e.g., workshops that had to be canceled, rescheduled, or had to switch from in person delivery to remote delivery. Can we record this in the database?

Yes. We have added a question on the workshop data entry screen to track workshops that have been impacted by, or implemented during, the COVID-19 pandemic. This will allow us to see how many workshops were impacted and, if needed, also remove these workshops from contributing to your organization/network’s overall participant retention rate.

The question is stated, “This workshop was impacted by COVID-19: Yes/No/Unknown.” Grantees do not need to add this question to data collection forms, but are welcome to do so if it would be helpful for their data entry personnel (e.g., add to the falls prevention or CDSME program information cover sheet). The image below demonstrates how this question will appear in the database.

Can we use the database to track which workshops are implemented remotely?

Yes. We have added two questions to the workshop data entry screen to track if programs were delivered remotely and, if so, what type of technology was used to deliver the program (e.g., Zoom, Facebook Live, OneClick, Other). The questions appear in the database as: “This workshop was implemented virtually: Yes/No/Unknown” and “If YES, what technology was used? Select all that apply.” The image below demonstrates how these questions will appear in the database.

How can we collect participant pre/post-program surveys for programs implemented remotely and enter the information into the CDSME and falls prevention databases?

The ACL falls prevention and CDSME pre/post-program surveys (located here for falls and here for CSDME) ask participants questions about personal health information (e.g., physical/mental health conditions) and personally identifiable information (e.g., name, zip code). These data are protected by the Privacy Act and therefore must be collected and transferred using secure, protected platforms.

NCOA is exploring a secure platform we can potentially make available to all grantees and leaders to collect participant pre/post-program surveys. We will announce new developments to grantees via email, as well as update the FAQs webpage.

In the meantime, grantees are welcome to electronically send participants surveys using secure platforms. After you retrieve the data from those platforms (typically downloaded as a spreadsheet), you may enter the data into the Falls Prevention or CDSME database, or into your own data management system. Follow the steps below.

  • Create your electronic participant pre/post survey using a secure data collection platform. We recommend using a HIPAA-compliant platform such as SurveyGizmo or JotForm.
  • Visit the Healthy Aging NC website for fillable versions of the required data collection forms for ACL grants, as well as a short video on the new CDSME forms.
  • After participants have completed the survey(s), export the survey data.
  • You may manually enter the survey data into the NCOA Falls Prevention or CDSME database, or into your own data management system, in the same way that you would enter paper survey forms.
  • For virtual programs, the host organization/implementation site will be the entity that is organizing the workshop, even if it is not physically held in that location.
  • If you use a third-party data management system (e.g., Workshop Wizard, Compass), you can then export the data from it and import it into the ACL Falls Prevention or CDSME database by using NCOA’s Data Migration Template. The falls template is here and the CSDME template is here. If you use the Data Migration Templates, send your completed data migration template to the Falls Prevention or CDSME Databases using a Safe File Transfer Protocol (SFTP) server. Falls grantees should send data to falls_data@ncoa.org, and CSDME grantees should send data to cdsmedb@ncoa.org or create a ticket in CHA Community 2.0 here.

For more information about data security practices and protocol, view the NCOA Privacy & Data Security guidebook.

When hosting virtual workshops, what should be entered as the host organization?

For virtual programs, the host organization should be the agency that has led coordination of the workshop. This could be the grantee organization or a partner. The host organization is often responsible for training master trainers and leaders/facilitators and for planning and monitoring the implementation of programs. Often (but not always) the host organization holds the program license.

When hosting virtual workshops, what should be entered as the implementation sites?

The implementation site is the physical location where the evidence-based program takes place in the community (i.e. the venue). Since no physical location is necessary for virtual workshops, you may do one of the following:

  1. The implementation site entered is identical to the host organization.
  2. The implementation site entered indicates a partner of the host organization (that would usually serve as the physical location of the workshop) that played a role in promoting or implementing the workshop.

Have others collected program data from participants by phone or online?

There are several ways to collect pre- and post- program data from participants remotely.

For programs conducted by phone, the program facilitator can collect pre-and post-workshop survey data from the participant either when they are registered for the program or by adding 15-20 min to the first session and last session. Some organizations have mailed a copy of the form with return postage for the participant to complete and send back.

For programs conducted by video-conference, the program facilitator or data manager can send all participants a link to complete the pre-workshop survey either as part of registering for the workshop or any time prior to joining the first session. The post-workshop survey can be provided as a link during or following the last session. Organizations have reported using SurveyGizmo or JotForm to collect information online.

Emergency Protocols

As you are forming trusting relationships with community members, it will be beneficial to share important updates and resources about the pandemic and other activities happening at your agency. Here are some examples from MAC, Inc. of what type of information you can provide.  

You can also direct older adults and caregivers to the NCOA webpage on COVID-19.

It is also essential for organizations to have an emergency protocol for remote delivery classes in place. Is emergency contact information collected for participants? If so, what should the leaders do if there is a safety concern? A policy, or similar document, should be developed and distributed to leaders.

Sustaining Remote Delivery of Evidence-Based Programs

New Partnerships and Contracting Opportunities

Do you work with health care partners to deliver services? Healthcare organization may be looking for unique and safe ways to keep their patients engaged. The remote delivery of evidence-based programs provides an opportunity for individuals to learn skills such as how to self-manage their chronic condition or how to reduce their fall risk. See examples from the field about what others have been doing to sustain or develop new contracts during this time.

In the NCOA COVID-19 survey, it was reported that the Aging Network has seen an increase in partnering with other community-based organizations. 45% of respondents shared that they were now working with health departments, and 40% are now working with municipal organizations.

Grand Rounds:

Resuming In-Person Programming

Once your organization begins to resume normal services and considers holding in-person programming again, it is important to do so with proper safety procedures in place and while practicing social distancing. We recommend you follow local, organizational, and state guidelines to guide these decisions.

For those that are considering in-person programming, here are some guides from the field.

 Grand Rounds:

In April, July, and October 2020, NCOA surveyed community-based organizations to understand how COVID-19 affected their services to older adults. From the survey, the following was shared on what the plan was for organizations regarding reopening plans.

Comprehensive Guides from the Field

Several organizations have leader toolkits that they are willing to share with the aging network. These comprehensive guides include everything from implementation to sustainability.

The Grand Rounds presentations can also be a great resource to hear firsthand from organizations who are implementing programming remotely:

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