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Programs & Organizations > Chronic Disease Prevention > A Guide For Local Health Departments > A Participatory Evaluation Approach
Preventing Chronic Disease
A Participatory Evaluation Approach
This Guide might have ended with a chapter on evaluation, but in our experience, it's best to think about evaluation right from the beginning. So we provide a few words about incorporating it into the planning process from the start. We offer further suggestions throughout the Guide.
Traditionally, evaluation occurs in response to a funder's mandate and focuses exclusively on whether the project accomplished the goals, objectives and activities outlined in a program plan. The evaluation is usually an internal process: agency staff, perhaps working with consultants, determine what will be studied and what methods will be used. The approach is usually to collect quantitative information, such as how many people participated in a program or attended a training session. The information may be shared in a limited way with the broader community.
The evaluation philosophy described here is quite different. It is based on a commitment to empower communities by making the evaluation process an ongoing, sustainable part of community planning and action. Our approach provides residents with skills and opportunities to help determine how the evaluation is designed. They decide what they want to evaluate and how they want to gather needed information. The residents participate in collecting and reviewing the information and help analyze and present the findings to the community. The information is used to monitor progress toward the community's goals and to adapt and sustain the effort.
The evaluation needs to be designed with feedback from all key stakeholders, including the community affected by the program, paid staff, volunteers and funders. Each stakeholder will have its own questions for the evaluation. A funder will probably want to see how many people received services, or whether certain materials were produced. Community members are more likely to care about the accessibility and quality of programs and the extent of neighborhood improvements that result from the efforts.
A good evaluation will attempt to balance the needs and interests of the various stakeholders. The process generally takes place at three levels:
Challenges in Evaluation
There are three major challenges we have found in evaluating chronic disease prevention programs developed with the community:
Demonstrating improved health outcomes can be difficult to accomplish in a relatively short time frame because the results of a chronic disease prevention program are, by definition, long-term. While mortality data for chronic diseases may be available at the county, city or zip code level, data at the neighborhood level is difficult to obtain. Incidence rates for chronic diseases are even more scarce, particularly for small population groups and geographic areas. As a result, it may be more feasible to track interim changes like:
Assessing the impact of your efforts to partner with the community and build community capacity also presents a challenge. High turnover among participants over the course of the project may make it difficult to develop sustainable relationships. The priorities of the community may shift as well, particularly in neighborhoods facing other, more urgent concerns. Activities, objectives and even goals of the project may change, making it hard to document the impact of your efforts.
To address some of these obstacles, you will need to:
The final challenge is finding the time and skill needed for a full evaluation. If you lack the staffing or funds for a complete evaluation, you can still do a simple one. First, consider limiting your evaluation to a few, primary objectives. Most funders are not looking for an in-depth evaluation of each aspect of the program.
Some strategies to consider if your resources are more limited include:
Content provided by the The Community Wellness & Prevention Program of Contra Costa Health Services.