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Moore’s Level 7, Community Health

Definition

The seventh level in one established outcomes framework, Moore’s Level 7 emphasizes the need to measure the change in community health outcomes that are associated with an educational intervention. Community health outcomes are defined as changes at the level of a group of patients whose care may not be directly attributable to a known learner or educational intervention.

 

Methods

A comparison of community health data may be derived from patient charts, electronic health records (EHR), epidemiology, claims-based system, or other appropriate data source.

Secondary method: An analysis of aggregate or average patient responses (across the community) to a health survey.

 

Evidence

Moore et al. JCEHP, 29(1):1–15, 2009.

 

Example

An educational activity focused on improving school nurse awareness and competency of managing students experiencing asthma symptoms. A six month evaluation of school attendance records found that absentee rate in participating schools decreased, even for students who have never been diagnosed with asthma.

 

Additional Contextual Information:

  • Please note that not everything from a chart meets the definition of Community Health outcomes. For instance, in the HF example above, readmission and adherence would be a Level 6 outcome, while therapy choice and screening would be a Level 5 outcome.
  • Since Level 7 is defined by the change in Community Health, data should be collected before and after the educational intervention. If statistical approaches are being applied, one must understand the limitations of such approaches.
  • For all practical purposes the distinction between Moore’s Level 6 (defined elsewhere in the glossary) and Moore’s Level 7 is minor. The details of the intervention and the methods to measure change require a much greater level of rigor and sophistication, and reporting the outcomes of Level 6 and Level 7 should include specific details of the rationale, implementation, and analysis in keeping with those expected by peer-reviewed publications.