A Methodology for Evaluating Organizational Change in Community-Based Chronic Disease Interventions

ArticleinPreventing chronic disease 4(4):A105 · November 2007with10 Reads
Source: PubMed
In 2003, the Monterey County Health Department, serving Salinas, California, was awarded one of 12 grants from the Steps to a HealthierUS Program to implement a 5-year, multiple-intervention community approach to reduce diabetes, asthma, and obesity. National adult and youth surveys to assess long-term outcomes are required by all Steps sites; however, site-specific surveys to assess intermediate outcomes are not required. Salinas is a medically underserved community of primarily Mexican American residents with high obesity rates and other poor health outcomes. The health department's Steps program has partnered with traditional organizations such as schools, senior centers, clinics, and faith-based organizations as well as novel organizations such as employers of agricultural workers and owners of taquerias. The health department and the Stanford Prevention Research Center developed new site-specific, community-focused partner surveys to assess intermediate outcomes to augment the nationally mandated surveys. These site-specific surveys will evaluate changes in organizational practices, policies, or both following the socioecological model, specifically the Spectrum of Prevention. Our site-specific partner surveys helped to 1) identify promising new partners, select initial partners from neighborhoods with the greatest financial need, and identify potentially successful community approaches; and 2) provide data for evaluating intermediate outcomes matched to national long-term outcomes so that policy and organizational level changes could be assessed. These quantitative surveys also provide important context-specific qualitative data, identifying opportunities for strengthening community partnerships. Developing site-specific partner surveys in multisite intervention studies can provide important data to guide local program efforts and assess progress toward intermediate outcomes matched to long-term outcomes from nationally mandated surveys.
    • "reduction in smoking behavior). Second, the socioecological model allows researchers to examine multiple overarching influences of a person " s health behaviors, and the interaction of these influences (Hanni, Mendoza, Snider, & Winkleby, 2007). Increasing our knowledge of the influence of parental health beliefs on their children " s health is relative to differences in psychological, cultural and environmental factors. "
    [Show abstract] [Hide abstract] ABSTRACT: Health beliefs contribute to health outcomes. These health beliefs extend to include health beliefs parents have regarding their children’s health. However, the role of parental health beliefs remains unexplored among a low-income population. This study aims to assess these beliefs and the effects they have on child health. Furthermore, this study aims to delineate potential belief differences between socioecological-level groups (e.g. population density, Latino identification, and insurance coverage). The long-term goal is to understand the relationships among various personal health beliefs and parental health beliefs, psychosocial factors, community factors, cultural factors, organizational factors, and healthcare perceptions among this at-risk population. Results from this study can further inform public policy and public health procedures. Advisor: Dennis McChargue
    Full-text · Article · May 2011 · Preventing chronic disease
    • "In 2003, the Monterey County Health Department in California was one of 12 initial sites selected to receive funding from the Steps Programs cooperative agreement with the Centers for Disease Control and Prevention (CDC). This funding is being used to implement a 5-year, community-based intervention to reduce the burden of diabetes, asthma, and obesity in Salinas (Hanni, Mendoza, Snider, & Winkleby, 2007; MacDonald et al., 2006). The intervention uses a multicomponent approach that includes developing partnerships with nontraditional partners, such as the owners of taquerias. "
    [Show abstract] [Hide abstract] ABSTRACT: As part of a 5-year community-based intervention in Salinas, California, the Steps to a Healthier Salinas team developed a taqueria intervention addressing obesity and diabetes among Mexican Americans. The authors present: (a) a comparison of service/entrée options for Salinas taquerias (n = 35) and fast-food restaurants ( n = 38) at baseline, (b) a case study of one taqueria, (c) a description of a healthy nutrition tool kit tailored to taquerias, and (d) an evaluation of the intervention at Year 3. It was found that traditional Mexican American-style menu offerings at taquerias tended to be healthier than American-style fast-food restaurant offerings. In addition, the initial response to the intervention has shown positive changes, which include the taqueria owners promoting available healthy menu items and modifying other menu offerings to reduce fats and increase fruit and vegetable availability. This, in turn, has led to a transition of the owners' perceptions of themselves as gatekeepers for a healthy community.
    Full-text · Article · Apr 2009
  • Article · Nov 2007
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