The Program Being Evaluated
Healthy Kids, Healthy Communities (HKHC) is a national program of the Robert Wood Johnson Foundation (RWJF) whose primary goal is to implement healthy eating and active living policy- and environmental-change initiatives that can support healthier communities for children and families across the United States. HKHC places special emphasis on reaching children who are at highest risk for obesity on the basis of race/ethnicity, income and/or geographic location.
The HKHC national program is the largest Robert Wood Johnson Foundation (RWJF) investment to date in community-level strategies to prevent childhood obesity. HKHC consists of two rounds of funding: (1) nine leading communities funded for five years, where significant progress is expected on policy and environmental changes to prevent childhood obesity; and (2) 41 communities funded for three years, where community leaders and advocates are poised for change, but have less experience in undertaking these changes.
About the Evaluation
There is very limited evaluation information about policy and environmental changes at the community level to prevent childhood obesity. This evaluation will ensure that systematic information about these issues will become available from HKHC. Plans for the evaluation consist of two parts: intensive evaluation of policy and environmental changes in at least 10 selected communities, and participatory evaluation of the remaining 41 communities, to mark milestones for accomplishment. The initial evaluation phase, which is underway, will prepare the foundation for a comprehensive examination of this national initiative. The lead evaluator is Laura K. Brennan, Ph.D., M.P.H., President and CEO of Transtria L.L.C., Saint Louis, Mo.
Summary of Methods
Activities for this initial evaluation phase include:
- Redevelopment of the Progress Reporting System (PRS) of the national program office (NPO), based on findings from the evaluation of the Active Living by Design initiative and input from the nine leading communities;
- Creating a toolkit of assessment and community measurement resources;
- Developing a protocol for evaluation together with the nine leading HKHC communities;
- Training staff and the nine leading communities on the revised PRS and the community-measurement toolkit; and
- Developing a protocol for technical assistance to the 50 HKHC grantees based on findings from the pilot with the leading communities.
The participatory evaluation will be accomplished in collaboration with the National Program Office through the use of an interactive web space that allows grantees, NPO and evaluators to track progress in real time. This web-based tool was a joint effort of the evaluation and the program staff. Community evaluation liaisons will input community-defined milestones for accomplishment with coaching and prompting from the program and evaluation staff.
Unlike the self-report of community accomplishments in the participatory evaluation, the in-depth evaluation of sample community efforts will require systematic observation, reliable recording and statistical analysis of changes. Consistent with evaluation resources, the evaluation team will study at least 10 communities for at least one audit of the food environment and one for physical activity. For example, the evaluation team might measure the safety, accessibility, quality and cultural relevance of park and playground facilities and the accessibility of outlets for healthy food. The choice of communities will depend on: (a) capacity and willingness to assist the evaluation team in carrying out the measurements; (b) variation in ethnicity and geographic location; (c) focus on features of the environment that are common among the 50 grantees; (d) the focus is guided by our best information to date on what works; (e) there is a good measurement tool to assess the results.
Products and Dissemination
The deliverables will include:
- A progress reporting system (PRS) that integrates intervention planning, evaluation and reporting to support HKHC grantees;
- A toolkit of assessment and evaluation resources recommending a range of methods, measures and data sources that can be tailored to the environment and policy strategies that HKHC grantees will plan and implement; and
- A training manual and associated tools or resources (e.g., skill-building activities, links to Web sites) to support the use of the PRS and the toolkit.
Both the participatory evaluation and the in-depth assessment of change will be provided as soon as information becomes available to inform the field.
While the need to address disparities in care is well known, few strategies for reducing disparities have been studied systematically.
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