William Beery

Policy-Contribution Assessment and Field-Building Analysis of the Robert Wood Johnson Foundation's Active Living Research Program

BACKGROUNDnThe Robert Wood Johnson Foundation requested this utilization-focused evaluation of its Active Living Research (ALR) program. This evaluation reports on the trajectory of influence of past and future ALR outcomes on field-building and policy contributions as well as on possible users of completed and disseminated ALR products.nnnMETHODSnIn 2006 and 2007, key-informant interviews were conducted with 136 representatives of first-line potential users of ALR research products, including state physical activity and nutrition program coordinators, policymakers, scientists, and funders. Literature reviews, bibliometric analyses, and document reviews served to describe the context for ALRs work and the ways it could enhance its utility for field building and policymaking.nnnRESULTSnThe contributions of ALR to the emerging transdisciplinary field included leadership in the development of measurement tools, epidemiologic studies, implementation research, the translation of research to practice, and the communication of learned lessons to diverse audiences. ALRs contributions to policy discussions were found across a spectrum of policy-development phases that included describing the problem, raising awareness of alternative strategies for increasing physical activity, convening nontraditional partners, and evaluating policy implementation.nnnCONCLUSIONSnPolicy-relevant research can make contributions to policymakers thinking but almost never causes a change by itself. Five years after the original authorization of ALR, there is ample evidence of its recognition as a resource by key players, its field-building influence, and its contributions to policy discussions. All these bear promise for a broader contribution to obesity prevention. Recommendations for increasing ALRs impact on policy and practice are offered.

Implementation of the Henry J. Kaiser Family Foundation's Community Health Promotion Grant Program: A Process Evaluation

The Community Health Promotion Grants Program, sponsored by the Henry J. Kaiser Family Foundation, represents a major health initiative that established 11 community health promotion projects. Successful implementation was characterized by several critical factors: (1) intervention activities; (2) community activation; (3) success in obtaining external funding; and (4) institutionalization. Analysis of the program was based on data from several sources: program reports, key informant surveys, and a community coalition survey. Results indicate that school-based programs focusing on adolescent health problems were the most successful in reaching the populations they were targeting. The majority of the programs were able to attract external funding, thereby adding to their initial resource base. The programs were less successful in generating health promotion activities and in achieving meaningful institutionalization in their communities.

The evaluation of the Henry J. Kaiser family foundation's community health promotion grant program: Design

The Kaiser Family Foundations Community Health Promotion Grant Program (CHPGP) provides funding and technical assistance in support of community-based efforts to prevent major health problems. The first phase of the program was implemented in 11 communities in the western United States. This paper describes the evaluation design of the CHPGP in the West, the methods of data collection, and the baseline comparability of intervention and control communities. Major features of the evaluation design include: (1) the randomization of qualified communities making application into funded and unfunded comparison groups; (2) a second set of matched control communities for some intervention sites; (3) data gathering through repeated surveys of community residents (probability samples of adults and adolescents) and institutions (health-related organizations and randomly sampled grocery stores and restaurants); and (4) the use of secondary data to monitor health events. Selected baseline data show that intervention and control communities differ in racial/ethnic composition, but relevant health behaviors and ratings of community activation for health promotion appear comparable.

Using the Concept of “Population Dose” in Planning and Evaluating Community-Level Obesity Prevention Initiatives:

When planning and evaluating community-level initiatives focused on policy and environment change, it is useful to have estimates of the impact on behavioral outcomes of particular strategies (e.g., building a new walking trail to promote physical activity). We have created a measure of estimated strategy-level impact—“population dose”—based on our work in evaluating obesity prevention initiatives that uses elements of the RE-AIM method of combining reach and effectiveness to estimate the impact of a strategy on risk behaviors within a target population. We provide a definition and examples of measuring population dose, discuss measurement options in the face of uncertainty about key parameters, review ways of increasing population dose, and illustrate how the concept of population dose has been used in the Kaiser Permanente Community Health Initiative.

The Impact of a Community-Based Chronic Disease Prevention Initiative: Evaluation Findings From Steps to Health King County:

Steps to Health King County (Steps KC; Seattle, Washington) was one of 40 community-level initiatives funded in 2003 as part of the Steps to a HealthierUS initiative. Steps KC goals included reducing the impact of chronic diseases through a comprehensive, coordinated approach and reducing health disparities due to chronic illness. Steps KC intervention activities took place on two levels: the overall Steps KC collaborative and individual funded programs. Collaborative-level activities included policy and systems change initiatives and efforts to better integrate the funded-program organizations. The funded programs ranged from group health promotion programs to intensive case management. Steps KC was successful in creating a large, diverse community collaborative and funding 14 separate programs that reached approximately 8,000 community residents with medium- and high-intensity programs of demonstrated effectiveness. Systems change initiatives within school districts and government agencies led to a greater institutional emphasis on health promotion and on partnership with communities to address health inequities.

A review of hospital-based health promotion programs in Michigan non-governmental hospitals

In 1983, the 217 hospitals of the Michigan Hospital Association (MHA) were surveyed to learn more about their efforts in health promotion programming. Eighty percent (174 hospitals) responded to the survey, with 48% reporting on 532 programs. Those programs included 216 in health promotion as defined by the survey instructions, 110 in disease management, 66 in first aid and safety, 87 screening, and 53 miscellaneous education programs. Further particulars about the programs are presented, including information regarding program audience, times offered per year, median enrollment, median participant hours, program age, number and type of educational methods used, follow-up methods, and fees charged. Hospital administrators perceptions regarding health promotion programs were also surveyed. They indicated a higher level of interest in providing such programs because they viewed them as a needed community service. Conversely, they did not see them as a revenue generator. Seventy-two percent of the responding administrators indicated they currently offered health promotion programs, although only 48% submitted information regarding them. Seventy percent said they planned to begin new health promotion programs within the next 12 months, while only 6% planned to discontinue programs in the new year.