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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

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evaluation framework promoting health through strengthening community action

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
Ottawa Charter for Health Promotion
  • One strategy: strengthen community action
  • Importance of concrete and effective community action in setting priorities,
    • making decisions,
    • planning strategies, &
    • implementing them to achieve better health.
  • WHO, 1986
2 programs in dthr to strengthen community action
2 programs in DTHR to strengthen community action
  • Healthy Communities Initiative
  • Health Promoting Schools Initiative
why the framework big picture
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
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
Why the framework:Evaluation picture
  • Safe & meaningful steps needed.
  • Simple data collection methods & tools required.
why the framework different pictures
Ongoing performance measurement

regularly reported

established expectations

accountability

Evaluation

as needed

unintended impacts

contextual factors

“why” questions

Why the framework: Different pictures
community 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
What are we building?
  • Shared vision
  • Participation
  • Leadership
  • Communication
  • Ongoing learning
  • Resources, knowledge & skill
  • Sense of community
slide11

Formation of Core Groups

Core Group

Adherence to principles?

Responsive?

Satisfaction with the process?

Perceived benefits of process?

Vision

Visioning

Adherence to principles?

Responsive?

Satisfaction with the process?

Perceived benefits of process?

Community Assessment

Community Profile

Adherence to principles?

Responsive?

Satisfaction with the process?

Perceived benefits of process?

Selection of Key Priority Areas

Key Priority Area(s)

Adherence to principles?

Responsive?

Satisfaction with the process?

Perceived benefits of process?

Action Planning

Action Plan(s)

Adherence to principles?

Implementation of Actions and Action Plan(s)

Effective? Efficient? Participation and partnerships?

Responsive?

Satisfaction with the process?

Perceived benefits of process?

change in community capacity

change in community capacity outcomes
Short term

Planning activities (benefits of process: e.g., shared vision)

Outputs (utility of product: e.g., vision)

Implementation of action plan (s)

Long term

community-level and school-level indicators (e.g., participation)

track and monitor measurable changes in community capacity

Change in community capacity:Outcomes
short term tools for evaluation
Short term: Tools for evaluation
  • Activities
    • Description, why, participation, collaboration, outcomes (e.g., core group, visioning).
    • Building understanding of health, building capacity for leadership, etc.
  • Process
    • Choose a number between 1 (low) - 5 (high) & explain.
    • Understanding the process, champions identified, visioning completed, actions planned
organizational capacity
Organizationalcapacity
  • “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)
change in organizational capacity outcomes
Short term

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

Integration/system alignment: goals & objectives are understood, integrated, & coordinated

Improved health and well-being: evidence from monitoring

Change in organizational capacity: Outcomes
short term example
Short term: Example
  • Organizational commitment
    • There is a shared understanding of what the community action team can achieve
    • There are champions of community action at the Authority and Senior management level
short term tools for evaluation18
Short term:Tools for evaluation
  • Activities
    • 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
    • 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

Where are we ...

Next steps:

Establish indicators for long term outcomes & performance measurement