1
|
Barasche-Berdah D, Wetzler S, Greenshtein I, Greenberg KL, Leiter E, Donchin M, Zwas DR. Municipal community centers as healthy settings: evaluation of a real-world health promotion intervention in Jerusalem. BMC Public Health 2022; 22:1870. [PMID: 36207706 PMCID: PMC9540711 DOI: 10.1186/s12889-022-14220-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 09/21/2022] [Indexed: 11/23/2022] Open
Abstract
Background This study presents an intervention designed to foster the implementation of health promotion programs within District Municipality Community Centers (DMCCs) in Jerusalem, and the creation of a peer network of healthy settings with a shared aspiration of collaborating and implementing health-promoting policies at the community level. We also present the evaluation strategy, based on the EQUIHP and RE-AIM frameworks. Methods Twenty DMCCs completed our program. This evaluation research involved a comprehensive seminar during the first year for DMCCs coordinators, teaching them the principles of health promotion. An educational kit was distributed during the second year. The evaluation strategy included a process evaluation and annual evaluations based on the EQUIHP and RE-AIM frameworks. The EQUIHP tool was divided into four dimensions of evaluation: 1) Framework of health promotion principles, 2) Project development and implementation, 3) Project management, and 4) Sustainability; while the RE-AIM domains included: 1)Reach, 2)Effectiveness, 3)Adoption, 4)Implementation and 5)Maintenance. Results The program led to high responsiveness among DMCCs and to the implementation of diverse health promotion initiatives, with a participation of approximately 29,191 residents. The EQUIHP evaluation showed an improvement in program quality in Year 2. The final RE-AIM evaluation presented a total median score of 0.61 for all domains, where 0 was non-performance and 1.0 was full performance. The ‘Framework of health promotion principles’ and ‘Reach’ components received the highest median score (0.83, 1.0 and 0.87), while the ‘Sustainability and ‘Maintenance’ components received the lowest (0.5). Conclusions This innovative program adapts the Healthy Cities approach (initiated by the World Health Organization in 1986) to the development of community center health-promoting settings within the larger municipal framework, training local community center staff members to assess and address local health concerns and build community capacity. The local focus and efforts may help community actors to create health promotion programs more likely to be adopted, feasible in the ‘real-world’ and able to produce public health impact in the communities where people live. Moreover, collaboration and cooperation among DMCCs may lead to a broader community health vision, forging coalitions that can advocate more powerfully for health promotion. Trial registration NIH trial registration number: NCT04470960. Retrospectively registered on: 14/07/2020. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-14220-7.
Collapse
Affiliation(s)
- Deborah Barasche-Berdah
- The Linda Joy Pollin Cardiovascular Wellness Center for Women, Hadassah University Medical Center, Ein Kerem, P.O.B. 12000, 91120, Jerusalem, Israel
| | - Sima Wetzler
- The Linda Joy Pollin Cardiovascular Wellness Center for Women, Hadassah University Medical Center, Ein Kerem, P.O.B. 12000, 91120, Jerusalem, Israel
| | - Iva Greenshtein
- The Linda Joy Pollin Cardiovascular Wellness Center for Women, Hadassah University Medical Center, Ein Kerem, P.O.B. 12000, 91120, Jerusalem, Israel
| | - Keren L Greenberg
- The Linda Joy Pollin Cardiovascular Wellness Center for Women, Hadassah University Medical Center, Ein Kerem, P.O.B. 12000, 91120, Jerusalem, Israel
| | - Elisheva Leiter
- The Linda Joy Pollin Cardiovascular Wellness Center for Women, Hadassah University Medical Center, Ein Kerem, P.O.B. 12000, 91120, Jerusalem, Israel
| | - Milka Donchin
- Israel Healthy Cities Network and Braun School of Public Health and Community Medicine, Hebrew University, Jerusalem, Israel
| | - Donna R Zwas
- The Linda Joy Pollin Cardiovascular Wellness Center for Women, Hadassah University Medical Center, Ein Kerem, P.O.B. 12000, 91120, Jerusalem, Israel.
| |
Collapse
|
2
|
Abildso CG, Bias TK, Coffman J. Adoption and Reach of a statewide policy, systems, and environment intervention to increase access to fresh fruits and vegetables in West Virginia. Transl Behav Med 2019; 9:847-856. [PMID: 31570923 DOI: 10.1093/tbm/ibz095] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Local public health professionals’ consistency, connections, and presence at meetings were critical to making changes in schools, farmers markets, and retail food stores to improve access to fruits and vegetables in rural, low-income food deserts.
Collapse
Affiliation(s)
| | - Thomas K Bias
- West Virginia University School of Public Health, Morgantown, USA
| | - Jessica Coffman
- West Virginia University Health Research Center, Morgantown, USA
| |
Collapse
|
3
|
Baugh Littlejohns L, Wilson A. Strengthening complex systems for chronic disease prevention: a systematic review. BMC Public Health 2019; 19:729. [PMID: 31185993 PMCID: PMC6558784 DOI: 10.1186/s12889-019-7021-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Accepted: 05/21/2019] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND While frameworks exist for strengthening health care systems and public health systems, there are no practical frameworks to describe, assess and strengthen systems for chronic disease prevention (CDP) using complex systems approaches. METHODS A systematic and integrative review of peer reviewed literature was conducted to answer the following questions: How can systems for CDP be defined? What are key attributes of effective systems? How are complex systems approaches discussed? Search terms were identified and the Medline, SCOPUS, and Global Health databases were searched December 2017 and January 2018. Reference lists and selected journals were hand searched. A working definition for a system for CDP was developed to provide a guideline for inclusion. Key exclusion criteria were literature did not address the research questions or working definition; was published in a language other than English and before 2000; focused on specific chronic diseases and/or risk factors and not CDP broadly; concentrated on the health care sector and clinical services and/or health status and surveillance data; and described evaluations of setting specific actions such as policies, programs, interventions, approaches, projects, laws, or regulations. Selected literature (n = 141) was coded in terms of the extent to which the research questions and the working definition of systems for CDP were addressed. Data was then analysed and synthesized to determine key themes. RESULTS A revised definition of systems for CDP and seven attributes of effective systems for CDP are reported (collaborative capacity, health equity paradigm, leadership and governance, resources, implementation of desired actions, information and complex systems paradigm). A framework was developed to provide a foundation for describing, assessing and strengthening systems for CDP. CONCLUSIONS The results of this literature review provide a strong foundation for a framework to help strengthen systems for CDP. The framework consolidates not only well-established attributes of effective CDP but also highlights theoretical and practical insights from complex systems perspectives.
Collapse
Affiliation(s)
- Lori Baugh Littlejohns
- Menzies Centre for Health Policy, The Australian Prevention Partnership Centre, D17 Charles Perkins Centre, University of Sydney, Sydney, NSW 2006 Australia
| | - Andrew Wilson
- Menzies Centre for Health Policy, The Australian Prevention Partnership Centre, D17 Charles Perkins Centre, University of Sydney, Sydney, NSW 2006 Australia
| |
Collapse
|
4
|
Townsend JS, Sitaker M, Rose JM, Rohan EA, Gardner A, Moore AR. Capacity Building for and Implementation of Policy, Systems, and Environmental Change: Results from a Survey of the National Comprehensive Cancer Control Program. Popul Health Manag 2018; 22:330-338. [PMID: 30332328 DOI: 10.1089/pop.2018.0082] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Policy, systems, and environmental (PSE) approaches are commonly used to improve population health. Cancer-related examples include providing data and education to stakeholders about policies that support healthy living, or health systems changes such as universal reminders about recommended cancer screening. The National Comprehensive Cancer Control Program (NCCCP) funds health departments to form cancer coalitions that develop and implement cancer plans. NCCCP initiated a demonstration program in 13 of 65 funded grantees to determine whether skilled, dedicated staffing and using a strategic process to examine data, form a workgroup, and develop an agenda would enhance their capacity to implement PSE approaches, recruit new partners, and provide data and education to stakeholders. The objective of this study was to compare demonstration program grantees to other NCCCP grantees on their ability to develop and implement PSE strategies, and the short-term results that were achieved. Program directors (PDs) from each NCCCP-funded jurisdiction completed web surveys at 2 time points during implementation to assess changes in their capacity for PSE approaches, identify implementation activities, and document short-term outcomes. Responses from demonstration program PDs and other PDs at both time points were compared in a descriptive analysis. Demonstration program grantees experienced greater increases in skills and capacity to address PSE approaches, engaged in necessary implementation activities more often, and achieved greater improvements in stakeholder and decision maker awareness and support for PSE strategies, compared to nonparticipating NCCCP grantees. These findings support continued implementation of PSE approaches for sustainable cancer prevention and control.
Collapse
Affiliation(s)
- Julie S Townsend
- 1Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | - John M Rose
- 2Battelle Memorial Institute, Columbus, Ohio
| | - Elizabeth A Rohan
- 1Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Annette Gardner
- 1Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Angela R Moore
- 1Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
| |
Collapse
|
5
|
Asada Y, Lieberman LD, Neubauer LC, Hanneke R, Fagen MC. Evaluating Structural Change Approaches to Health Promotion: An Exploratory Scoping Review of a Decade of U.S. Progress. HEALTH EDUCATION & BEHAVIOR 2017; 45:153-166. [DOI: 10.1177/1090198117721611] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Structural change approaches—also known as policy and environmental changes—are becoming increasingly common in health promotion, yet our understanding of how to evaluate them is still limited. An exploratory scoping review of the literature was conducted to understand approaches and methods used to evaluate structural change interventions in health promotion and public health literature. Two analysts—along with health sciences librarian consultation—searched PubMed, Web of Science, and EMBASE for peer-reviewed U.S.-based, English language studies published between 2005 and 2016. Data were extracted on the use of evaluation frameworks, study designs, duration of evaluations, measurement levels, and measurement types. Forty-five articles were included for the review. Notably, the majority (73%) of studies did not report application of a specific evaluation framework. Studies used a wide range of designs, including process evaluations, quasi- or nonexperimental designs, and purely descriptive approaches. In addition, 15.6% of studies only measured outcomes at the individual level. Last, 60% of studies combined more than one measurement type (e.g., site observation + focus groups) to evaluate interventions. Future directions for evaluating structural change approaches to health promotion include more widespread use and reporting of evaluation frameworks, developing validated tools that measure structural change, and shifting the focus to health-directed approaches, including an expanded consideration for evaluation designs that address health inequities.
Collapse
Affiliation(s)
- Yuka Asada
- University of Illinois at Chicago, IL, USA
| | | | | | | | | |
Collapse
|
6
|
Hannon PA, Vu TT, Santiago PM, Joyner P, Mason C, Harris JR. Prevention Research Center Collaborations With State Departments of Health: Washington State. Am J Prev Med 2017; 52:S246-S249. [PMID: 28215373 DOI: 10.1016/j.amepre.2016.07.027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2016] [Revised: 07/11/2016] [Accepted: 07/29/2016] [Indexed: 10/20/2022]
Abstract
State health departments and Prevention Research Centers (PRCs) have complementary mandates and expertise important to improving population health. State health departments manage and administer numerous programs with broad population reach. PRCs bridge dissemination and implementation research and public health practice to improve health programming and outcomes. This paper describes the 15-year partnership between the Washington State Department of Health and the PRC at the University of Washington. Through this partnership, the Washington State Department of Health increases their research and evaluation capacity by working with the University of Washington PRC, and the University of Washington PRC receives opportunities to apply evidence in a variety of practice settings, expand the reach of their research-tested programs to new populations, and form new partnerships. The partnership focused initially on improving colorectal cancer screening rates through increased dissemination and implementation of evidence-based interventions. The partnership scope has grown to include small cancer screening projects in worksites and healthcare systems, Washington's Colorectal Cancer Control Program, breast and cervical cancer screening, hypertension control, and worksite health promotion. The partnership yields three main types of outcomes that strengthen practice and science: (1) findings from each major assessment or evaluation activity, published in the peer-reviewed literature when possible; (2) use of the findings to improve public health practice and impact; and (3) training opportunities for employees of local and state health departments and public health students. PRCs, health departments, and the populations they serve have much to gain from this type of partnership.
Collapse
Affiliation(s)
- Peggy A Hannon
- Health Promotion Research Center, A CDC Prevention Research Center, Department of Health Services, University of Washington, Seattle, Washington;.
| | - Thuy T Vu
- Health Promotion Research Center, A CDC Prevention Research Center, Department of Health Services, University of Washington, Seattle, Washington
| | | | - Pama Joyner
- Office of Healthy Communities, Washington State Department of Health, Olympia, Washington
| | - Caitlin Mason
- Health Promotion Research Center, A CDC Prevention Research Center, Department of Health Services, University of Washington, Seattle, Washington
| | - Jeffrey R Harris
- Health Promotion Research Center, A CDC Prevention Research Center, Department of Health Services, University of Washington, Seattle, Washington
| |
Collapse
|