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Evaluating Community-Based Health Improvement Programs.

Carrie E Fry1, Sayeh S Nikpay2, Erika Leslie3

  • 1Carrie E. Fry ( carrie_fry@g.harvard.edu ) is a doctoral student in health policy at the Harvard Graduate School of Arts and Sciences, in Cambridge, Massachusetts.

Health Affairs (Project Hope)
|January 9, 2018
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Summary
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Community health programs showed no significant impact on obesity, health status, or smoking rates. Funders should improve program evaluation methods for better health outcome assessment.

Keywords:
Determinants Of HealthHealth Promotion/Disease PreventionPublic HealthTobacco/Smoking

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Area of Science:

  • Public Health
  • Health Services Research
  • Community Health Interventions

Background:

  • Growing investment in community-based health improvement programs.
  • Current program evaluations often lack rigorous comparison groups and rely on process data.
  • Need for robust methods to assess program impact on health outcomes.

Purpose of the Study:

  • To determine the association between community-based health improvement programs and county-level health outcomes.
  • To address limitations in current program evaluation methodologies.
  • To inform future program design and funding.

Main Methods:

  • Utilized publicly available county-level data (2002-2006).
  • Employed propensity-weighted control groups for multiple regression analyses.
  • Compared health outcomes in program implementation counties versus non-program counties.

Main Results:

  • No statistically significant changes in obesity rates, self-reported fair/poor health, or smoking rates were observed.
  • Observed decreases in obesity and fair/poor health were less than 0.15%.
  • Program counties exhibited higher poverty and unemployment rates and younger populations.

Conclusions:

  • Current community-based health improvement programs, as evaluated, did not demonstrate significant positive health outcomes.
  • Socioeconomic and demographic factors in program counties may influence implementation and outcomes.
  • Enhanced guidance and expertise in measurement and analytics are crucial for effective program evaluation from the outset.