13.10.3: Goals, Objectives, and Activities

A goal of a program is the overarching target that the program is attempting to accomplish. This is usually stated in a single sentence, and encompasses the general mission of the program. Below are some examples of program goals:

• To increase the number of adults achieving the minimum physical activity recommendations.
• To help breast cancer patients access social support resources.
• To reduce teen violence incidents in high school.

Goals are written in a very broad and general way, but include both who will be affected (target population) and what will be changed (outcome) (Seabert et al., 2021).

Objectives are specific outcomes that will lead to the overall goal being achieved. Objectives come in different forms, and must be written in a very specific way, as they are typically describing outcomes that are measured at the beginning and end of the program in order to determine its effectiveness. Well-written objectives follow the SMART acronym:

• S - specific. The objective states specifically what will change, and by how much. It should be stated in quantifiable terms.
• M - measurable. The objective needs to have a metric that will be measured at the beginning and end of the program (or part of the program). Vague objectives such as changing things like knowledge or perceptions can often be measured by validated surveys or tests, which can be quantified (represented numerically) by a score.
• A - achievable. The objective has to be achievable given the resources available and the baseline measurement. This is where the scientific evidence - studies of previous interventions - can help the program planner set reasonable expectations.
• R - realistic. The objective must be realistic for the given timeframe. Not only should these objectives be evidence-based, they should also be realistically achievable for the target community. If more or fewer resources are available, or if a shorter or longer timeframe is utilized, that can change the effectiveness of the program.
• T - timeframe. All objectives should have an “end date”, or date which the objective is re-measured. This may not be the end date of the program itself, particularly if it is an ongoing project, but it will be the target date for the completion of the objective, and the evaluation of the program.

Compare the following objectives against the SMART acronym:

• In the next 6 months, program participants will improve their scores on the single-leg balance test by 10%.
• Senior citizens will improve their balance.
• The community pool will be utilized more by the end of the year.
• More children will know how to swim at the end of the summer.
• The employees of the local grocery store chain will have no low back pain complaints by the end of the year.

The first objective is the only one that follows all of the guidelines in the SMART acronym. It provides a specific population (program participants), a specific measurement (score on the single-leg balance test), and a specific, achievable outcome (improvement by 10%), as well as a realistic timeframe (6 months).

Objectives can be set for different aspects of the program. Some objectives will be process objectives, or targets of the implementation of the program itself. Process objectives might include activities like:

• Distributing a specific number of flyers.
• Hiring personnel (e.g. a Registered Dietician)
• Recruiting participants (getting people to sign up for the program)
• Purchasing equipment
• Conducting a certain number of health education classes

Impact objectives include outcomes that affect the target population’s learning, behaviors, or environment. For example, learning objectives assess the knowledge or skills obtained, such as:

• Test scores on a written test.
• Survey results identifying knowledge of a specific resource.
• Pass rate of a skills test.

Behavioral objectives include specific behaviors performed by community members. These could be things like:

• Getting blood pressure, cholesterol, or blood glucose levels checked.
• Performing regular exercise.
• Reporting consumption of fruits and vegetables.
• Attendance in support group meetings.

Environmental objectives include changes to the environment in which the target population lives, works, or plays. For example:

• The city enacts smoke-free policies in all public places.
• There is no longer a waitlist for the seniors free-lunch program.
• Cardiopulmonary Resuscitation (CPR) classes are offered every weekend at the community center.

Lastly, outcome objectives are the actual measures that will lead to the overarching goal of the program. These are health outcomes that address the health problems identified in the needs assessment. Some examples might be:

• A decline in the number of teen pregnancies.
• Improvements in Health-Related Quality of Life (HRQL) as reported on a community-wide survey.
• Program participants decrease their body mass index (BMI).

Designing the intervention itself will typically include activities or specific actions or pieces of the program which are designed to achieve the objectives. If possible, these activities should be evidence-based, or at least based on previous best-experiences (whether or not these prior interventions have been published as peer-reviewed research). Typically, multiple activities tend to be better than a single activity (Seabert et al., 2021). Community members and key stakeholders can provide invaluable feedback on whether planned activities are likely to work within a particular community. The cultural values, beliefs, attitudes, and behaviors of the target population are important to understand before designing a program - otherwise it may not be well-received or at worst, it may make the health problem worse. Lastly, behavioral change theories and models can be useful in this stage to help inform the program design and select the appropriate activities.

Figure \(\PageIndex{1}\): A Biology for Public Health course at Galena High School in Missouri. (Photo credit: CDC/Ryan Lacson, 2019)

This photograph depicts Ryan Lacson, a high school biology teacher and 2019 Centers for Disease Control and Prevention (CDC) Science Ambassador Fellow, as he was leading a Biology for Public Health course at Galena High School in Missouri. To design the course, Lacson used his experience as a Science Ambassador Fellow, and partnered with his county health department to identify the county's most pressing public health issues. As part of the course, students partnered with a local community organization to train other high schoolers on mental health first aid.