Projects

Legacy evaluation

The Partnership for the Public's Health
The California Endowment (TCE), 2007–2008
The Partnership for the Public’s Health (PPH) was a progressive five-year initiative to build the capacity of California communities and local health departments to work together to improve health and create policy and system changes that support community health improvement. CCHE is currently conducting a legacy evaluation of the initiative to assess its long term impact and document best practices and lessons learned. The legacy evaluation includes site visits with 12 partnerships (11 PPH partnerships and 1 non PPH partnership), key informant interviews with public health experts, and dissemination of PPH evaluation findings through a variety a publications and a conference exploring the ways health departments and community groups work together to achieve common goals. In July 2008 CCHE organized a TCE-sponsored one-day conference focusing on public health-community partnerships, “Evidence. Equity. Empowerment. Evolution.” Case studies and other reports related to the PPH Initiative are also available.

Understanding the Legacy of the Sabbatical Program
The California Wellness Foundation (TCWF) 2007–2008
The Sabbatical Program aims at encouraging and preserving the leadership of community-based non-profit organizations concerned with health. Organizations demand a great deal from their executive directors and require that highly talented, energetic individuals occupy that position. Stress and burnout often result, leading to reduced executive director effectiveness or turnover. The Sabbatical Program seeks to promote retention and preserve the effectiveness of community-based organization executive directors by providing opportunities for rest and rejuvenation. The Center for Community Health and Evaluation (CCHE) team received a grant to address questions about the overall impact and legacy of the program, and to make recommendations to TCWF for program improvement.

Legacy of Ten Years of Community Grantmaking
 Northwest Health Foundation (NWHF), 2007
CCHE designed and conducted an assessment of the contribution the Northwest Health Foundation has made to communities as a result of its history of grantmaking. Included in the assessment was consideration of 300 community grants over the last ten years. The evaluation focused on understanding the impact of grantmaking to the organization and the local community, the legacy of the funding and an assessment of the relationship between the Foundation and organizational recipients. Results of the evaluation are detailed in the final report, Legacy Illuminated.

Read the executive summary (PDF). For copies of the full report, please contact Emily Bourcier, bourcier.e@ghc.org.

Tracks in the Sand: Sustainability of Community Health Initiatives
The California Wellness Foundation (TCWF), 2004–2006
Ten years ago, TCWF invested more than $100 million in five multi-year initiatives to improve the health of communities through a variety of prevention, development, and direct-service interventions. TCWF contracted with our evaluation team to determine the extent to which the project elements established under three of the initiatives were sustained three to four years after TCWF funded ended. In this evaluation, titled Tracks in the Sand, our team conducted site visits and interviews with the 85 original grantees to assess long-term sustainability and impact of the initiatives.

Read the final report: On Sustainability—Assessing the Long-Term Impact of Three TCWF Initiatives (PDF) [also available at: http://www.tcwf.org/
pub_reflections/nov_2006.htm]

Health Improvement Initiative
The California Wellness Foundation, 2001–2002
Our team conducted an evaluation of this five-year (1996–2001) Health Improvement Initiative. In 2002, we completed an assessment of the legacy of the initiative—the degree to which its contributions to systems change and health improvement were sustained one year post-funding. The final report included the identification of factors associated with sustainability of community efforts.

Read the executive summary: Health Improvement Initiative: Legacy Evaluation Report: Executive Summary (PDF)

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Community-based health improvement programs

Community Health Initiative
Kaiser Permanente, 2003–2011
CCHE has been chosen by Kaiser Permanente (KP) to serve as the national cross-site evaluators for its Community Health Initiative—a component of KP's community benefit program in each of eight regions. The goals of the evaluation are to improve program performance, demonstrate impact, and contribute to the evidence and share learning about these types of community-based strategies. In 2009, the evaluation was expanded to include 21 LiveWell Colorado communities.

Joint Evaluation of Specialty Care Initiative
California HealthCare Foundation and Kaiser Permanente Community Benefit Program, 2008–2011
CCHE is conducting a three-year evaluation of a joint initiative funded by the California HealthCare Foundation and Kaiser Permanente Community Benefit Program. The grant initiative is funding 20–25 community-based coalitions throughout California dedicated to developing and implementing strategies to improve access to specialty care. Using a participatory approach and a range of qualitative and quantitative data collection methods, the evaluation seeks to assess the impact of the initiative, identify best practices and highlight factors associated with sustainability of the community coalitions. CCHE will also be providing technical assistance to grantees to increase their capacity to develop their own evaluation plans and collect and report on a common set of measures related to specialty care access.

Safety Net Partnerships
Kaiser Permanente, 2008–2009
Kaiser Permanente regions are implementing health care improvement strategies in Safety Net partnerships.  This project will describe the mix and scale of strategies being pursued in three regions (Colorado, Georgia and Northern California). CCHE’s evaluation will also identify, pilot and assess approaches for measurement of intermediate and long-term outcomes.

ALL/PHASE Initiative in the Safety Net
Kaiser Permanente, 2008-2009
Cross-site evaluation of 16 community clinics and public hospital systems implementing ALL/PHASE, a population-based intervention to decrease cardiovascular morbidity and mortality among high-risk patients. The evaluation described implementation to date, identified factors associated with more successful programs, and made recommendations to help improve the approach.

Educational Theatre Program
Kaiser Permanente, 2008-2009
CCHE is assessing improvements in elementary school students’ knowledge of healthy eating and active living topics following Educational Theatre Program (ETP) interactive performances in selected schools in seven KP regions. The assessment includes analysis of pre-, post- and delayed surveys of students who participated in the ETP performances. CCHE also will determine the value and feasibility of expanding the scope of the evaluation to assess other outcomes of the ETP.

Evaluation of Foundation Initiatives
Foundation for a Healthy Kentucky, 2007–2009
CCHE is conducting evaluations of three of the Foundation for a Healthy Kentucky's initiatives—Access to Primary Care, Health Advocacy, and Local Data for Local Action. The long-term outcomes for all three of the initiatives are to increase access to health services for all Kentuckians and to create environments that support and promote healthy lifestyles. CCHE has convened a national advisory panel to guide this evaluation and has contracted with two Kentucky-based evaluators to serve as our local presence. The evaluations are each guided by an initiative logic model, evaluation questions and indicators. To answer the evaluation questions, CCHE is using diverse data collection methods including grantee site visits and surveys, key informant interviews, media and legislative tracking, and secondary data analysis. Along with the evaluation, CCHE is providing evaluation technical assistance to the grantees involved in each of these initiatives. 

Growing Up Healthy: Kids and Communities
The Blue Cross/Blue Shield of Minnesota Foundation (BCBSMF), 2004–2009
CCHE is evaluating the foundation's ten-year initiative which focuses on partnerships to improve the health of children through three sectors: early childhood development; housing; and the environment. In addition, CCHE consulted with BCBSMF as it developed and adopted its new program directions to address the social, economic, and environmental determinants of health. We prepared environmental scans, a series of expert colloquia, regional forums, issue papers, and funding guidelines

Steps to a Healthier SE Alaska
Southeast Alaska Regional Health Consortium, 2007–2008
The SEARHC Steps to a Healthier SE Alaska program works with schools, worksites and other community groups to increase physical activity, encourage healthy eating and reduce tobacco use. CCHE's evaluation emphasizes intermediate outcomes, such as systems and policy change, while at the same time establishing measurement approaches to track changes in long-term community health outcomes.

Steps to a HealthierUS—King County
U.S. Centers for Disease Control, 2003–2008
King County, Washington is one of seven urban areas across the country initially chosen to implement Steps to a HealthierUS, a program to promote healthy lifestyles in the areas of asthma, diabetes, obesity, nutrition, physical activity, and tobacco. CCHE is leading the multi-year local evaluation and participating in the national evaluation.

Steps to a HealthierUS—Colville Tribal Nation
Washington State Department of Health, 2005–2006
CCHE designed a series of needs assessments targeting asthma, diabetes, obesity, nutrition, physical activity, and tobacco on the Colville Indian Reservation in Northeast Washington. Three community surveys included interviews of business council representatives, community residents, and workplace employees.

Health Trek
Group Health Community Foundation (GHCF) and Aramark, 2005–2007
Health Trek was the GHCF nutrition and fitness program providing teacher workshops, exhibits, and curriculum materials to middle schools in Washington. With additional funding from Aramark, CCHE monitored program implementation and assessed the effectiveness of the program components in a unique program.

Allies Against Asthma
Robert Wood Johnson Foundation, 2001–2005
A locally created coalition of stakeholders designed this coordinated approach to asthma control. CCHE took the lead role in assessing program implementation, including contributions of interventions with families, social networks, community groups, faith communities, schools, housing agencies, and health care providers. We recommended ways to strengthen relationships among coalition member groups and improve the overall management of asthma.

New Program Directions
The Blue Cross/Blue Shield of Minnesota Foundation (BCBSMF), 2004–2005
The evaluation team consulted with BCBSMF as it developed and adopted new program directions to address the social, economic, and environmental determinants of health. Our team prepared environmental scans, a series of expert colloquia, regional forums, issue papers, and funding guidelines. BCBSMF is interested in the health implications of the built environment/housing, social integration of recent immigrant populations, and early childhood interventions.

The Partnership for the Public's Health
The California Endowment (TCE), 2000–2005
The Partnership for the Public’s Health (PPH) was a $40 million, five-year initiative that partnered 39 community organizations with 14 health departments. The main goal of PPH was to build the capacity of California communities and local health departments to work together to improve health and create policy and system changes that support community health improvement. Our team tracked progress and challenges in key program areas: building capacity at the partnership and health department levels, partnership development, health improvement, and policy change.

Read the final report and executive summary:

Sun Safe Communities
American Cancer Society (ACS), 2001–2002
One of ACS's goals is to reduce sun exposure. In this project, six communities located on the Eastern seaboard and in New Mexico were targeted for program materials to reduce sun exposure. ACS staff and volunteers joined with schools, preschools and daycare centers, parks and recreation organizations, primary care physicians, and media outlets to promote sun safety among young people, their parents, and caregivers. The evaluation focused on documenting the progress and achievements in each site, immediate and intermediate outcomes of the project, lessons learned, and implications for future skin-cancer prevention efforts.

Health Improvement Initiative
The California Wellness Foundation, 1996–2003
This $20 million grant-making program, which provided funding to 15 communities throughout California, focused on systems change, policy change, and improved prevention services.The evaluation assessed achievements in program implementation, use of data for decision-making, and sustainability; the type and volume of prevention services provided; and measurable community health outcomes.

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Assessment and design of community health initiatives

Children's Access Fund
Group Health Community Foundation, 2007–2008
In fall 2006, Group Health Cooperative awarded $1 million to the Foundation to support improvements in children's access to health care outside of King County, Washington. CCHE has consulted on developing criteria and guidelines for selecting programs to fund, provided evaluation planning assistance to grantees, and is responsible for evaluation the overall Children's Access Fund initiative.

Secondhand Smoke—Workplace Assessment
Public Health–Seattle & King County, Tobacco Prevention and Local Hotel Employees and Restaurant Employees International Union, 2004–2005
This evaluation assessed local workers' exposure to secondhand smoke, presence of stressful working conditions, and exposure to hazardous chemicals among local hotel and restaurant workers. Results have been used by union and public health officials to plan training programs that address identified workforce needs.

Strategy Guide for Bar Owners
Public Health–Seattle & King County, Tobacco Prevention, 2003–2004
CCHE prepared and disseminated a publication as an extension of the secondhand smoke assessment project (see above). The publication was a guide for local bar and tavern owners to use in planning smoke-free events and to assist them in implementing longer-range plans to become completely smoke-free.

Assessment of Developers' Attitudes Toward Public Health Amenities
Public Health–Seattle & King County, Tobacco Prevention, 2004
This evaluation focused on understanding local business developers' interest in exchanging public health amenities for design and building incentives. Our team collaborated with Public Health–Seattle & King County to design, implement and analyze the results of this survey. Results have been presented at national conferences and incorporated into work sponsored by the University of Washington's Department of Urban Design and Planning.

Read the executive summary: Report on Interviews with Developers and Public Planners: Study on Incentives and the Built Environment (PDF)

Washington Coalition for Promoting Physical Activity Washington State Coalition for Promoting Physical Activity, 2003–2004 CCHE coordinated and supported the creation of a local coalition that seeks to promote physical activity. Activities included grant writing, facilitating leadership team meetings, establishing committees, coordinating annual statewide professional development, a coalition Web site, and speakers bureau.

Secondhand Smoke, Smoke-free Policies, and Tobacco Marketing in Bars and Nightclubs
Public Health–Seattle & King County, Tobacco Prevention, 2002–2003
CCHE assessed attitudes toward secondhand smoke, smoke-free policies, and tobacco marketing in bars and nightclubs that cater to the college-age community in Seattle. Results included recommendations on strategies to reduce smoking and exposure to secondhand smoke in bars and taverns in King County.

Tobacco Prevention Needs Assessment with the Tulalip and Stillaguamish Tribes
Snohomish Health District, 2002–2003 Under contract with the Snohomish County Health District in Everett, Washington, CCHE collaborated with two local tribes (Tulalip and Stillaguamish) to understand the role tobacco plays in their lives. The assessment sought to understand the cultural context of tobacco, current tribal policies toward tobacco, accessibility of smoking-cessation services, and current opportunities for tobacco prevention. The final report included recommendations to the tribes and health district for programming, monitoring, and evaluation.

Youth Takin' On Tobacco (YTOT)
State of California Department of Health Services, Tobacco Control Section, 1997–2000
The YTOT initiative implemented strategies to reduce the risk of tobacco use among young people in six California cities. The programs stressed a youth development approach to strengthen community engagement, personal development, and social development. CCHE provided technical assistance to each city's own evaluation efforts and assessed the project's overall impact.

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Evaluation planning

Healthcare Georgia Foundation Evaluation Planning Project and Evaluation Model Scan
Healthcare Georgia Foundation (HGF), 2006–2008
CCHE is working with the staff and governance leadership of HGF to design a comprehensive evaluation strategy for the foundation. The first step included identifying indicators to assess the difference the foundation is making in its three funding priority areas (strengthening nonprofit health organizations, expanding access to primary care, and addressing health disparities). We have also completed a national scan of models of support for nonprofit grantee evaluation and are currently assessing the evaluation needs of health-related nonprofit organizations in Georgia.

Health Care Leadership Initiative
2002–2003
ACS collaborated with the Memphis Business Group on Health to launch this initiative. The initiative involved ACS building relationships with employers and offering them strategies to prevent cancer, and when cancer does occur, to reduce its impact on both the employees and the company. CCHE designed an evaluation plan and provided planning support to this ACS pilot project.

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Diversity in health care

Social Justice Fund (SJF)
Social Justice Philanthropy Northwest, 2005–2007
The evaluation sought to answer questions about the operation and impact of SJF, a philanthropic organization based in Seattle that serves communities in six western states. Evaluation activities focused on a grant from the W.K. Kellogg Foundation to increase the involvement of people of color in philanthropy—as members, volunteers, and leaders.

Group Health Permanente Leadership Assessment
Group Health Permanente (GHP), 2005–2006
CCHE collaborated with GHP Human Resources to assess opportunities and barriers associated with leadership positions among Group Health physicians. Special interest was placed on understanding the attitudes and opinions of ethnic/racial minority and female physicians.

Cultural Competency Review
Group Health Cooperative, 2004–2005
CCHE completed a literature review on cultural competency issues in health care. Results were used by the Quality Division of Group Health to inform its strategic planning.

HR Leadership Diversity Assessment
Group Health Community Foundation, 2004–2005
This assessment was designed to gain a deeper understanding of the lack of racial and ethnic diversity within the Group Health workforce, explore issues that might affect participation in a career development program, and describe potential participants' current skills and career goals. This assessment informed the design and delivery of a career development program for managers funded by the Foundation.

Diversity Initiative
Group Health Community Foundation, 2003–2005
The Foundation funded this program to provide opportunities for students of color to prepare for and succeed in health careers. CCHE assessed the impact of the health-career school pathways program, subsequent school and career choices among participating students, challenges, and lessons learned.

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Program and service improvement

Sustainability of Community Health Initiatives
Kaiser Permanente, 2009
Kaiser Permanente (KP) is developing approaches to support and promote sustainability of its Community Health Initiative (CHI) goals. CCHE was asked to review literature on sustainability as well as assess  the status of CHI sustainability plans including progress toward goals and challenges in each of KP's eight regions.

Evaluating Innovative Approaches to Improving Health Care through CareOregon’s CSSI Program
CareOregon, 2007–2008
CareOregon, a nonprofit Medicaid health plan in Oregon committed to improving and protecting the health of low income and vulnerable Oregonians. CareOregon created the Care Support and System Innovation (CSSI) Program in 2004 to promote quality improvement among health care providers. The goal of the program was to improve quality of care among CareOregon providers and find a more effective way to increase compensation to providers rather than small incremental increases to reimbursement. The program was structured around the Model for Improvement approach to clinical quality improvement (QI), which emphasizes defining aims, measures and changes and doing Plan, Do, Study, Act (PDSA) Cycles. CareOregon contracted with CCHE to conduct an evaluation of the CSSI Program. The primary goals of the evaluation were to document the value of the CSSI Program and to identify areas for program improvement.

Read the executive summary (PDF) and findings brief (PDF).

Plan/Practice Improvement Project
California HealthCare Foundation, 2006–2007
CCHE, in partnership with Dr. Mangione-Smith at the Child Health Institute evaluated the Plan/Practice Improvement Project (P/PIP). P/PIP was an innovative quality improvement collaborative focused on asthma care. The Center for Health Care Strategies (CHCS) partnered with the Medi-Cal Managed Care Division, the National Initiative on Improving Children's Healthcare Quality (NICHQ), and the Improving Chronic Illness Care (ICIC) program of the MacColl Institute for Healthcare Innovation to lead this quality improvement collaborative. The major goal of the collaborative was to aid Medi-Cal health plans in synchronizing their quality improvement and chronic care management approaches at the health plan and provider levels. The evaluations main objective was to assess the effectiveness of the collaborative in supporting improvements asthma care within Medi-Cal practice sites.

Optimizing Healing in Primary Care
Group Health Center for Health Studies (CHS), 2005–2008
The goal of this research, co-sponsored by CHS and the Samueli Institute, is to develop, implement, and evaluate an intervention to produce the best possible primary care outcomes for chronic conditions. CCHE is assisting with qualitative data collection and analysis.

Hope Lodge Assessment
American Cancer Society (ACS), 2006–2007
ACS supports 22 Hope Lodges—free, temporary housing facilities for cancer patients who are undergoing treatment and for their caregivers. CCHE worked with ACS to assess the lodges for purposes of communicating best practices, to a case statement for fundraising, and to offer recommendations for the development of additional lodges.

Breast and Cervical Cancer Early Detection Program Collaborative Retreat Model
2006–2007
The ACS Breast and Cervical Cancer Early Detection Program Collaborative Retreat Model was developed to improve collaborations between state departments of health and ACS. The primary purpose of the CCHE evaluation was to assess the contribution of the retreats on functioning and strength of the collaboration, the retreats' contribution to cancer screening rates, and to provide feedback for improving the Retreat Model.

Physician Detailing Pilot Program
American Cancer Society, 2005–2007
ACS launched a pilot program to encourage physicians to use colorectal cancer prevention teaching materials with their patients. Our team assessed implementation of the program in six ACS divisions and designed an evaluation plan to measure long-term impact.

Youth Suicide Prevention in Washington State
Washington State Department of Health (WSDOH), 2003–2004
As part of the ongoing WSDOH programming effort to reduce teen suicides, the Youth Suicide Prevention Program was established to raise awareness about the danger signals surrounding youth suicide and increase knowledge of local intervention services throughout Washington. Our team conducted a community assessment to identify factors associated with establishing successful community prevention networks and the best ways to build community capacity. Results were used to inform ongoing suicide prevention efforts in Washington state.

Patient Navigator
2002–2003
The goal of the ACS Navigation Demonstration Project was to increase utilization of care support services among those affected by cancer. CCHE assessed how cancer patients and their caregivers requested and used services at ACS units, gauged their levels of satisfaction with services, and made recommendations for formal implementation of the navigation system.

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Health-related training programs

Understanding Childbirth Education
Lamaze International, 2004–2006
The assessment provided descriptive information on childbirth education classes with a particular focus on how information is conveyed in childbirth classes, contextual factors shaping how childbirth educators organize and select teaching materials and classroom exercises, and women's attitudes and behaviors regarding childbirth education. Methods included observation of childbirth education classes, interviews with instructors and students, survey data, and document review.

Senior Leaders Development Program
Group Health Cooperative, 2005
Group Health has designed a year-long program focusing on leadership development to prepare top internal candidates for senior-level positions. CCHE provided evaluation services to assess participant and senior leaders' satisfaction with the program and identify opportunities for improvement.

Northwest Center for Public Health Practice
Northwest Center for Public Health Practice, 2001–2007
The Northwest Center's mission is to improve the quality and effectiveness of public health practice by linking public health academic and practice communities in the Northwest (Alaska, Washington, Oregon, Montana, Wyoming, Idaho). CCHE provides consultation and expertise to support the evaluation of Northwest Center's ongoing training programs and projects and assists in the development of training programs related to evaluation. CCHE also conducts specific evaluation projects in collaboration with the Northwest Center such as preparedness training "needs assessments" with American Indian tribes in Washington, Oregon, and Idaho; the Oregon State Department of Human Services; and the states of Wyoming and Montana.

Project Public Health Ready: Thurston County Workforce
Northwest Center for Public Health Practice and Thurston County Department of Health, 2003
Thurston County was one of 12 demonstration sites for "Project Ready," which sought to prepare local governmental public health agencies to respond to public health emergencies. Partnering with the Northwest Center, our team completed an assessment of bioterrorism competencies and training needs among public health workers in Thurston County. The evaluation report informed a two-year strategic plan implemented by Thurston County Public Health.

Emergency Preparedness of the Wyoming Public Health Workforce
Northwest Center for Public Health Practice and State of Wyoming, 2003
In collaboration with the Northwest Center, this survey assessed Wyoming's public health and emergency response workers' competencies and training needs associated with bioterrorism preparedness.

Emergency Preparedness of the Montana Public Health Workforce
Northwest Center for Public Health Practice and State of Montana, 2003
In collaboration with the Northwest Center, this survey assessed Montana public health and emergency-response workers' training needs associated with bioterrorism preparedness. It included public health workers throughout the state and representatives from the seven Indian Nations in Montana.

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Policy analysis

Active Living Research (ALR)
The Robert Wood Johnson Foundation (RWJF), 2006–2007
ALR is a $12.5 million national program of RWJF that supports research to identify environmental factors and policies that influence physical activity. Findings from this research are used to help inform policy, design of the built environment and other factors to promote active living. The CCHE evaluation assessed the extent to which ALR is contributing to policy activity and the building of a field in active living/healthy eating.

Rural Caucus Consultant Evaluation
The California Endowment (TCE), 2005–2006
TCE introduced a strategic policy approach to provide research and analytic support to the California State Legislative Rural Caucus. Our evaluation examined the effectiveness of the program design and statewide policy impacts.

Read the final report: The Designation of Rural Areas in California: A Public Policy Case Study (PDF)

Assessment of Developers' Attitudes Toward Public Health Amenities
Public Health–Seattle & King County, Tobacco Prevention, 2004
This evaluation focused on understanding local business developers' interest in exchanging public health amenities for design and building incentives. Our team collaborated with Public Health–Seattle and King County to complete this survey project. Results have been presented at national conferences and incorporated into subsequent work sponsored by the University of Washington's Department of Urban Design and Planning.

Read the executive summary: Report on Interviews with Developers and Public Planners: Study on Incentives and the Built Environment (PDF)

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