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Assessing Rural Health Coalitions Using the Public Health Logic Model: A Systematic Review.

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Rural community health coalitions often report early-stage successes but rarely demonstrate significant health impacts. Standardizing logic model pathways may improve their effectiveness in improving rural health outcomes.

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Area of Science:

  • Public Health
  • Community Health
  • Health Services Research

Background:

  • Rural communities face significant health disparities due to limited healthcare access and resources.
  • Community health coalitions are vital for addressing local health needs through policy-system-environment changes.
  • Standardized evaluation is crucial for assessing the variable success of these coalitions.

Purpose of the Study:

  • To retrospectively assess rural community health coalitions using the W.K. Kellogg Foundation Logic Model.
  • To explore coalition-reported pathways through the logic model using market basket analysis.
  • To identify factors contributing to coalition success and areas for improvement.

Main Methods:

  • Systematic literature search of PubMed, Web of Science, ScienceDirect, CINAHL, and PsycINFO for relevant studies.
  • Review of full-text, peer-reviewed articles meeting PICOS criteria (Population, Intervention, Comparator, Outcomes).
  • Categorization of coalition-reported pathways according to logic model components and market basket analysis.

Main Results:

  • The most frequently reported pathway items included partner diversity, organizational structures, pilot studies, funding, and community engagement.
  • Half of the coalitions reported multiple key elements like funding, diverse partners, university collaborations, and community outreach.
  • Many coalitions reported inputs and capacity-building activities, but few demonstrated direct health impacts.

Conclusions:

  • Rural community health coalitions frequently engage in early-phase logic model activities but often fail to achieve significant health outcomes.
  • Recommending common, early-phase logic model pathways could potentially facilitate greater downstream success.
  • Further research is needed to refine evaluation methods and enhance the impact of rural health coalitions.