July 23, 2020
We've learned over the past 30 years about the central role that health care safety net providers (e.g., Federally Qualified Health Centers, free clinics, public hospital systems) play in supporting the health and well-being of people living in underserved communities. As a result, we have committed to partnering with funders and other organizations on initiatives that support safety net improvements and innovations to improve community health.
Our evaluations are designed to identify promising practices that support peer learning, provide timely feedback for initiative improvement, and use data to inform future investments. Currently, we’re seeing our safety net partners stretch in new ways as they build capacity and systems for delivering virtual care and build or maintain a strong focus on equity and reducing disparities in access and health outcomes.
For more than 10 years, CCHE has partnered with Kaiser Permanente’s (KP) Community Health Programs to evaluate its safety net initiatives. We recently released a new report on the impact of PHASE (Preventing Heart Attacks and Strokes Everyday). PHASE is a long-term initiative in Northern California that focuses on spreading a KP evidence-based, population management approach for patients most at-risk for heart attacks and strokes. Through PHASE, KP has provided grants and technical assistance to its safety net partners since 2006. PHASE currently engages six health center organizations, four regional clinic consortia representing 32 health center organizations, and four public hospitals from 18 counties across Northern California.
Through our evaluation of PHASE over the past decade, we have learned that:
These lessons have guided PHASE in its current pivot to supporting the safety net’s ability to care for patients at risk of heart attacks and strokes while responding to COVID-19.
June 5, 2020
At CCHE, we join our communities in mourning the murders of George Floyd, Breonna Taylor, Ahmaud Arbery, and far too many others across our country. CCHE stands in solidarity with people in this country who have experienced injustice for far too long. CCHE recognizes that police violence against black, indigenous, and people of color is a symptom of deeply rooted institutionalized racism and a systemic problem that we cannot ignore.
In quality improvement work we often talk about how “every system is perfectly designed to get the results it gets.” The painful reality is that our systems are achieving exactly what they were designed to do—protect the privileged at the expense of everyone else. Racism is a well-documented, well-researched public health crisis, and we at CCHE have a responsibility to speak up and be part of the solution. Community leaders and advocates have tried for decades to mend our systems, and that’s not working; we need to dismantle and rebuild these systems if we want to truly interrupt institutional racism at its source.
CCHE is committed to equity and we believe that equity needs to be at the center of all public health and health care investments if we want to improve the health and well-being of everyone. As evaluators, we recognize that we have power and influence to advance the conversation and prompt action to rebuild more equitable and just systems. We recognize that while we don’t have the answers for the best way to do this work, we haven’t pushed ourselves and our partners enough to think about and prioritize equity. We will make mistakes as we try to do better at living our values— knowing it will be difficult and awkward at times does not mean we should choose not to act.
We are committed to deepening our reflection, learning, and efforts to use our power and privilege to name the inequity and racism that we see in the systems around us and contribute to building more just systems. In our evaluation work we will:
We have a lot of work to do. It won’t be easy, and we are grateful for our community health partners going forward.
Photo by Maria Oswalt on Unsplash
May 28, 2020
Over the past 30 years, one consistent evaluation theme that emerges is the importance of leadership. A strong program or initiative without a strong leader and leadership buy-in cannot achieve its goals. Leadership can manifest in many different ways and sometimes comes from unexpected people or entities who have a commitment and passion for the work.
For nine years, CCHE has been partnering with the Public Health Institute’s Center for Health Leadership and Practice to evaluate its National Leadership Academy for the Public’s Health (NLAPH). NLAPH is designed to build leadership capacity and strengthen multi-sector collaboration for community health initiatives throughout the United States. Using skills and tools learned through NLAPH, participants are better able to support the systems changes necessary to improve community health and achieve health equity.
Within eight NLAPH cohorts, we’ve found that the program has created significant and sustainable changes in the leadership of its participants—enabling them to grow as individual leaders, develop as a team, and make meaningful progress on a project in their communities. A survey and interviews with alumni showed that most are still using skills and tools from NLAPH and feel that participation positioned them to take on and lead other community health improvement efforts. Read more about the lasting impact of participating in NLAPH in our alumni report.
We’ve also learned about which qualities of individuals and teams position them to have a positive impact on the health of their communities. These include having individuals that are mission-driven and committed to the work and team members who were in a position to navigate power dynamics and political processes to make change. Learn more about the factors that influenced teams’ ability to have an impact at the individual, team, and community level in our report on the impact of NLAPH.
May 5, 2020
During our 30 years of evaluation experience, CCHE has seen time and time again that many organizations don’t have the tools they need to meet funder requirements for showing results or to understand whether their programs are achieving their goals.
In response, 23 developed the Measuring What Matters curriculum and toolkit to support nonprofits, community collaboratives, and funders who want to understand how their programs are making a difference and communicate the results.
Based on CDC's Framework for Program Evaluation in Public Health, our self-service toolkit breaks down the six key phases of evaluation into understandable steps that nonprofits can use to see if they are making progress, learn how to improve programs in real time, and share results with their stakeholders, including funders. Each section includes templates that users can adapt for their own programs and initiatives. CCHE also uses the toolkit for in-person or online training to build evaluation capacity with organizations that want to dig in deeper.
We created Measuring What Matters because we believe that strong evaluation capacity is a cornerstone of building the community infrastructure that organizations need to promote equitable solutions to some of today’s most complex problems.
Download the complete toolkit or individual components from the CCHE Measuring What Matters page.
April 8, 2020
One thing we’ve learned at CCHE over the course of 30 years, is that change happens when communities come together and partner to identify and implement solutions that fit for their community. Because of this power of coming together, we find ourselves missing the time and space to be in-person connecting, learning, and innovating with all of you.
We also know the negative impacts of crises are not born equally or equitably, particularly by people of color and those who are low income, which makes our work together to improve health equity, during this pandemic, more important than ever.
We see these two themes—the benefits of coming together and the call to address health equity—converging in our work to evaluate SPARCC, a complex systems change initiative, recently published in a report on SPARCC’s blog. SPARCC has always been about building relationships and connections, and that shows up in effective collaborations in its six sites. Since its formation, SPARCC has had an ambitious goal—help shift decades of racial discrimination in housing and community development, affecting equity, health, and climate resilience.
February 25, 2020
Community health initiatives seek to improve policies, programs, and neighborhood environments. Over the past 30 years, we’ve learned that we need multiple strategies to combat complex problems. These can include focused programs targeting relatively few people, such as classes on how to cook healthy meals, combined with policy and environmental ones that reach everyone in a community, like increasing the amount of healthy food in grocery stores. How can we combine the effects of different strategies to strengthen their overall impact?
Dose methods allow us to add up the impact of very different strategies using a common yardstick. Dose combines reach—the number of people affected by a strategy—and strength—the degree to which those people change their behavior.
Using dose we can compare, for example, building sidewalks to increase walkability (high-reach, low-strength) to a daily walking group (low-reach, high-strength). Dose also helps focus attention on ways of increasing effect of initiatives—greater scale (reach) and greater impact (strength) on each person reached. We’ve distilled our learnings in a toolkit that can be used to plan and evaluate complex community initiatives, particularly those focused on healthy eating and active living.
Learn more about dose and download the dose toolkit
January 31, 2020
This is a landmark year for us—the 30th year since we began evaluating community-based health initiatives. It’s been a wonderful journey partnering with an incredible diversity of communities, organizations, funders, and others to further our collective mission of improving community health.
We began in 1990 with a contract awarded to the Group Health Center for Health Promotion to evaluate a national health promotion initiative. Through this and subsequent evaluations, the evaluation team, which would later form CCHE, began learning about what works to conduct a meaningful evaluation of community health improvement strategies.
Along the way we have shared what we were learning with the field about the importance of engaging stakeholders in all phases of an evaluation, focusing on realistic outcomes that matter and can be expected to change during the course of the initiative, using data collection methods that balance rigor and burden on participants, andregularly sharing back information and insights with all partners.
This continuous learning informs how we approach evaluation. As we reflect on our 30 years of work, we want to thank each of you for your partnership in improving the health of our communities.
Over the past 30 years, we have:
We look forward to continuing to learn with you the best ways to improve community health.