The 130th Annual Meeting of APHA

Abstract #49476

Shoshanna Sofaer, DrPH, School of Public Affairs, Baruch College, 17 Lexington Avenue, Box C401, New York, NY 10010, (212) 802-5980, shoshanna_sofaer@baruch.cuny.edu

A theory of action (TOA) specifies a series of assumptions about how an initiative or program will move from baseline conditions to the achievement of long-term goals. The evaluation team of the Community Care Network (CCN) Demonstration used the TOA as a major tool to work with and learn about CCN partnerships. In this session we will (1) present the general TOA we developed to specify the assumptions of the national CCN program; (2) discuss how this TOA helped guide the identification of key evaluation questions and needed evaluation data; and (3) describe “localized” TOAs as they emerged in on-site meetings between evaluators and small groups of CCN partners. We will emphasize how articulating a TOA supports the use of realistic strategies to move from short-term collaborative initiatives to the gradual achievement and institutionalization of the ambitious CCN vision of a health care system that (1) invests in improving community health, (2) is truly accountable to the community, and (3) creates a seamless continuum of health care and related human services for residents while (4) managing within limited resources. We will discuss challenges inherent in developing a TOA, such as the need to identify evidence that the initiatives planned are likely to have desired consequences and the impact on participants of recognizing the complexity of achieving systems change. We will also discuss how a community oriented partnership can engage the creativity and realism of community members to increase the viability of its TOA.

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