Evaluating community-driven initiatives focused on policy, systems, and environmental change: Lessons learned from building model communities in suburban cook county, Illinois

Evaluation of prevention strategies is an essential component of public health research especially in the face of new weight being placed on strategies that deliver specific, measurable health outcomes to address chronic disease. Evaluation can help to refine program delivery, gauge effectiveness, and provide evidence for continuing support. However, few resources exist to guide evaluation of community-driven policy, systems and environmental (PSE) change initiatives. In alignment with The National Prevention Strategy, the Model Communities (MC) program implemented in suburban Cook County, Illinois aimed to transform communities and schools to facilitate healthy living. As part of Communities Putting Prevention to Work, MC grants were awarded to 38 local governments, school districts, and community-based institutions to advance PSE changes to promote healthy eating and active living. The MC program supported grantees in building alliances and organizational capacity using a multi-pronged training and technical assistance strategy. Two-hundred PSE changes occurred in 127 schools and 73 communities across the region reaching nearly 1.6 million people. Evaluation of the MC program was based on a theory of change, and used mixed methods including surveys, interviews, and document review. While there were positive aspects of how the evaluation was structured, integrated, and conducted, challenges related to the complexity of the intervention, methodology, and organization, made it difficult to identify associations between PSE achievement and elements of the program. This presentation will highlight successes and limitations to the MC evaluation design and execution, and share recommendations for evaluating future community-driven health promotion initiatives focused on PSE change.