Transcript Evaluation framework: Promoting health through

Evaluation framework:
Promoting health through
strengthening community
action
Lori Baugh Littlejohns
& Neale Smith
David Thompson Health Region,
Red Deer, Alberta
Ottawa Charter for
Health Promotion
 One strategy: strengthen community action
 Importance of concrete and effective
community action in setting priorities,
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making decisions,
planning strategies, &
implementing them to achieve better health.
 WHO, 1986
2 programs in DTHR to
strengthen community action
 Healthy Communities Initiative
 Health Promoting Schools Initiative
Why the framework:
Big picture
 We are working with evolving new theory
of how to best partner with communities
that has not yet been fully proven in
practice.
 There are essentially no established ways to
measure the success of these new strategies
and approaches.
Why the framework:
Practice picture
 Community action requires new skills of
health care = not well understood: lack of
support for participatory methods.
 Health care workers perceptions of
evaluation = performance appraisal.
 Community members skepticism of
evaluation = lack of integration & learning.
Why the framework:
Evaluation picture
 Safe & meaningful steps needed.
 Simple data collection methods & tools
required.
Why the framework:
Different pictures
 Ongoing
performance
measurement
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regularly reported
established
expectations
accountability
 Evaluation
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as needed
unintended impacts
contextual factors
“why” questions
Evaluation framework:
2 core concepts
 Community
capacity
 Organizational
capacity
Community capacity
 “the ability of people and communities to
do the work needed in order to address the
determinants of health for those people in
that place”
 Bopp, GermAnn, Bopp, Baugh Littlejohns, & Smith (2000)
What are we building?
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Shared vision
Participation
Leadership
Communication
Ongoing learning
Resources, knowledge & skill
Sense of community
Formation of Core Groups
Responsive?
Adherence to
principles?
Satisfaction with
the process?
Perceived benefits
of process?
Core Group
Vision
Visioning
Responsive?
Adherence to
principles?
Satisfaction with
the process?
Perceived benefits
of process?
Community Assessment
Responsive?
Adherence to
principles?
Satisfaction with
the process?
Perceived benefits
of process?
Selection of Key Priority Areas
Responsive?
Adherence to
principles?
Satisfaction with
the process?
Perceived benefits
of process?
Action Planning
Community Profile
Key Priority Area(s)
Action Plan(s)
Responsive?
Adherence to
principles?
Satisfaction with
the process?
Perceived benefits
of process?
Implementation of
Actions and Action
Plan(s)
Effective? Efficient?
Participation and
partnerships?
change in community
capacity
Change in community capacity:
Outcomes
 Short term
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Planning activities
(benefits of process:
e.g., shared vision)
Outputs (utility of
product: e.g., vision)
Implementation of
action plan (s)
 Long term
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community-level and
school-level indicators
(e.g., participation)
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track and monitor
measurable changes in
community capacity
Short term: Tools for evaluation
 Activities
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Description, why, participation, collaboration,
outcomes (e.g., core group, visioning).
Building understanding of health, building
capacity for leadership, etc.
 Process
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Choose a number between 1 (low) - 5 (high) &
explain.
Understanding the process, champions
identified, visioning completed, actions planned
Organizational capacity
 “the potential ability of a health
organization to develop an empowering and
democratic partnership with a community,
through which the community’s capacity to
identify and address health concerns is
strengthened”
 K. GermAnn (2000)
Building organizational capacity:
Examples from logic model
Inputs
Activities
Outputs
Reach
facilitators skill dev
cohesive
teams
Dthr
mgmt
grants
culture
shared
vision
com
leaders
contracts w
partners
info
school
boards
networks
# schools
media
Outcome Outcome
(short)
(long)
Change in organizational capacity:
Outcomes
 Short term
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Org commitment to
supporting community
action
Resources to make it
possible ...
Org structures that
make it possible ...
Behavioral processes
or internal climate that
models ...
 Long term
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Integration/system
alignment: goals &
objectives are
understood, integrated,
& coordinated
Improved health and
well-being: evidence
from monitoring
Short term: Example
 Organizational commitment
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There is a shared understanding of what the
community action team can achieve
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There are champions of community action at
the Authority and Senior management level
Short term:Tools for evaluation
 Activities
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e.g., description (best practice? # people? who
was involved? what difference?) of the school
health workshop & how it built understanding
among Public Health staff.
 Process
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e.g., on a scale from 1 -5 how much progress
was achieved this year with respect to PH
staff’s understanding of HCI/HPSI process?
Where are we ...
Next steps:
Establish indicators for long term outcomes
& performance measurement