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DNP 815 W7 Discussion Question Two

DNP 815 W7 Discussion Question Two


Research change theories in scholarly literature and on the Internet. Develop a scenario and describe application of a change theory from the perspective of an advanced practice nurse leader.

Theory of Change (ToC) is a methodology for planning, participation, and evaluation that is used in companies, philanthropy, not-for-profit and government sectors to promote social change. Theory of Change defines long-term goals and then maps backward to identify necessary preconditions.[1]

Theory of Change explains the process of change by outlining causal linkages in an initiative, i.e., its shorter-term, intermediate, and longer-term outcomes. The identified changes are mapped – as the “outcomes pathway” – showing each outcome in logical

DNP 815 W7 Discussion Question Two

DNP 815 W7 Discussion Question Two

relationship to all the others, as well as chronological flow. The links between outcomes are explained by “rationales” or statements of why one outcome is thought to be a prerequisite for another.[2]

The innovation of Theory of Change lies (1) in making the distinction between desired and actual outcomes and (2) in requiring stakeholders to model their desired outcomes before they decide on forms of intervention to achieve those outcomes.

Theory of Change can begin at any stage of an initiative, depending on the intended use. A theory developed at the outset is best at informing the planning of an initiative. Having worked out a change model, practitioners can make more informed decisions about strategy and tactics. As monitoring and evaluation data become available, stakeholders can periodically refine the Theory of Change as the evidence indicates. A Theory of Change can be developed retrospectively by reading program documents, talking to stakeholders, and analyzing data. This is often done during evaluations reflecting what has worked or not in order to understand the past and plan for the future.


DNP 815 W7 Discussion Question Two


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Theory of Change emerged from the field of program theory and program evaluation in the mid 1990s as a new way of analyzing the theories motivating programs and initiatives working for social and political change.[3] Its earlier origins can be traced to Peter Drucker’s articulation of Management by Objectives, popularized in his 1954 book The Practice of Management. Management by Objectives requires identifying higher-order Goals, and lower-order Objectives which, if achieved, are expected to result in the Goals being achieved. Theory of Change extends beyond Goals (commonly named Outcomes in Theory of Change terminology) and Objectives to include Impact – the anticipated result of achieving stated goals.

Theory of Change is focused not just on generating knowledge about whether a program is effective, but also on explaining what methods it uses to be effective.[4] Theory of Change as a concept has strong roots in a number of disciplines, including environmental and organizational psychology, but has also increasingly been connected to sociology and political science.[5] Within industrial-organizational psychology, Austin and Bartunek have noted that approaches to organizational development are frequently based on more or less explicit assumptions about 1) the processes through which organizations change, and 2) the interventions needed to effect change.

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