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Creating and Evaluating Systems Change through a Participatory
Planning and Evaluation Model
Ron Hale, MS, NM Department of Health Office of Community
Health Partnerships; Victoria Sanchez, DrPh, University of New
Mexico; Yolanda Cruz, San Miguel Family and Community Health
Council
Background: New Mexico’s Community Health Councils are community-based
health coalitions located in each of the state’s 33 counties
and in several Native American tribal communities. New Mexico
is one of 13 states that have centralized (non-county-based) health
departments, resulting in a need for community health assessment,
planning, and coordination at the local level. Community Health
Councils support public health core functions, including assessment,
policy development, and assurance. Health councils mobilize communities
to address locally-identified priority issues, such as diabetes
and obesity prevention, teen pregnancy prevention, substance abuse
and mental health issues, and access to primary health care. Theoretical
framework: Our goal was to develop and implement a statewide planning
and evaluation model as a way of organizing and describing the
work of community health coalitions around common, systems-level
outcomes—programs, policies, services, and practices. The model was
developed through a participatory process that has allowed for local
identification of community needs, strategies, and health priorities.
Hypothesis/research questions: Community Health Councils can
accomplish changes in community systems and capacity that are likely
to contribute to community health improvement. A central research
question is: Can a statewide planning framework tied to intermediate,
systems-level outcomes be designed and implemented for use with allvolunteer
community coalitions with minimal staffing and training? A
secondary question is: Can evaluation data be collected from diverse
communities through the use of a web-based data reporting system?
Methods/interventions: Over the last four years, the NM Dept.
of Health (NMDOH), faculty from the Master of Public Health
Program (University of New Mexico) and health council coordinators
and members have co-developed and implemented a statewide
planning and evaluation framework. The purpose of the planning
framework was to guide the development of community health plans
in each of 37 communities. The plans incorporated common elements:
community assessment, problem analyses, identification of priorities,
system outcomes, objectives, and partnerships. We developed an online
data collection system for councils to report on their systems-level
outcomes and indicators. Results/conclusion/implications for practice:
Evaluation results show that community health councils can be an
effective strategy for accomplishing community capacity and systems
outcomes.
Results of a Participatory Policy Study in a Northern New
Mexico Community
Yolanda Cruz, San Miguel Family and Community Health Council;
Ron Hale, MS, San Miguel Family and Community Health Council;
Victoria Sanchez, DrPh, University of New Mexico; Perdita Wexler,
MA, NM Department of Health/Diabetes Prevention and Control
Program
Background and theoretical basis: Community partnerships are a common
mechanism to bring public health agencies, CBOs, citizen associations,
university researchers and others together to assess, plan and
act to ameliorate health problems in geographic or relational communities.
We report on results of a university/community/agency participatory
research study to examine school health policy, analyze success,
gaps, and identify policy areas to serve as a foundation for community
mobilization to reduce youth obesity. Methods and interventions:
We conducted key informant interviews with school administrators
to learn about formal and informal nutrition and physical activity
policies. We also conducted two focus groups with middle school and
high school students to examine how school policies influence students’
eating and physical activity during the school day. Community
and agency research partners co-developed the interview guides and
conducted the interviews. Research team members reviewed interview
transcripts and contributed to the coding scheme and interpretation of
the data. Our preliminary analysis focused on: 1) barriers and facilitators
of physical activity and nutrition policies; 2) recommendations to
improve policy implementation in the school districts and; 3) recommendations
for health council involvement. Key facilitators included
grant funding and a wellness policy champion; key barriers included
limited understanding and accountability for enforcement of the policies.
Our analysis identified ways that the Community Health Council
could serve as a linking agent with the broader community to improve
the implementation of school health and wellness policies, including
outreach and education to parents and community and strengthening
the communication linkages among existing groups to support school
wellness policies. Our team has continued to work with the community
health council and school districts to co-develop next steps in
support of physical activity and nutrition policies. Partnerships: We
are a university-community-state health agency partnership engaged
in a long-term collaboration with one of New Mexico’s 37 community
health councils. Implications for improved research, policy & practice:
Integrating a community-based, participatory research approach to
inform public health programs and practice in communities offers an
important resource to improve the link between research and practice.
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SOPHE-NACDD 2011 Joint Academy and Midyear Scientific Meeting