The Program Sustainability Assessment Tool: A New Instrument for Public Health Programs

TLDR

Public health programs must sustain activities over time, yet despite many frameworks, few reliable assessment tools exist. This study introduces the Program Sustainability Assessment Tool (PSAT), a new instrument designed to reliably measure a program’s capacity for sustainability. The PSAT was developed through a measurement study involving 592 staff from 252 public health programs across four chronic‑disease areas, resulting in a 40‑item scale covering eight sustainability domains. Confirmatory factor analysis confirmed the eight‑domain structure, subscales showed excellent internal consistency (α 0.79–0.92), and preliminary validation linked PSAT scores to key program and organizational characteristics, demonstrating its reliability.

Abstract

Public health programs can deliver benefits only if they are able to sustain programs, policies, and activities over time. Although numerous sustainability frameworks and models have been developed, there are almost no assessment tools that have demonstrated reliability or validity or have been widely disseminated. We present the Program Sustainability Assessment Tool (PSAT), a new and reliable instrument for assessing the capacity for program sustainability of various public health and other programs.A measurement development study was conducted to assess the reliability of the PSAT. Program managers and staff (n = 592) representing 252 public health programs used the PSAT to rate the sustainability of their program. State and community-level programs participated, representing 4 types of chronic disease programs: tobacco control, diabetes, obesity prevention, and oral health.The final version of the PSAT contains 40 items, spread across 8 sustainability domains, with 5 items per domain. Confirmatory factor analysis shows good fit of the data with the 8 sustainability domains. The subscales have excellent internal consistency; the average Cronbach's α is 0.88, ranging from 0.79 to 0.92. Preliminary validation analyses suggest that PSAT scores are related to important program and organizational characteristics.The PSAT is a new and reliable assessment instrument that can be used to measure a public health program's capacity for sustainability. The tool is designed to be used by researchers, evaluators, program managers, and staff for large and small public health programs.