The Program Sustainability Assessment Tool: a new instrument for public health programs

Area of Science:

• Public Health
• Program Evaluation
• Health Services Research

Background:

• Sustaining public health programs is crucial for long-term benefits, yet reliable assessment tools are scarce.
• Existing sustainability frameworks lack validated and widely disseminated measurement instruments.
• The Program Sustainability Assessment Tool (PSAT) was developed to address this gap.

Purpose of the Study:

• To introduce and evaluate the reliability and validity of the Program Sustainability Assessment Tool (PSAT).
• To provide a standardized instrument for assessing the sustainability capacity of public health programs.

Main Methods:

• A measurement development study involving 592 program managers and staff from 252 public health programs.
• Participants rated program sustainability using the PSAT across chronic disease program types (tobacco, diabetes, obesity, oral health).
• Reliability was assessed using internal consistency (Cronbach's α) and factor analysis.

Main Results:

• The final PSAT has 40 items across 8 domains, demonstrating good fit with confirmatory factor analysis.
• Subscales showed excellent internal consistency, with an average Cronbach's α of 0.88 (range 0.79–0.92).
• Preliminary validation indicated PSAT scores correlate with key program and organizational characteristics.

Conclusions:

• The PSAT is a reliable and valid instrument for measuring public health program sustainability capacity.
• The tool is suitable for use by researchers, evaluators, and program managers in diverse public health settings.
• PSAT can support efforts to enhance the long-term effectiveness of public health initiatives.