Abstract
Structural change approaches, also called policy, systems, and environmental change approaches, have been increasingly promoted and adopted by public ealth agencies in the past decade. These interventions require attention to multilevel, complex and contextual influences on individual and community health outcomes, requiring a sound theoretical framework that links the many processes and outcomes over time. The Model Communities program of Cook County, Illinois Communities Putting Prevention to Work program employed a theory of change (ToC) framework to inform the evaluations’ design and execution. The main objective of this study was to apply findings from the longitudinal multiple case study evaluation to develop an adapted ToC. We conducted 97 key informant interviews across three waves, with a focus on Model Communities program participants’, Communities Putting Prevention to Work staff, and technical assistance providers’ experiences over time. Four analysts organized and coded the data using qualitative software; exploratory functions and data matrices were employed throughout three waves of analysis. Adaptations to the ToC included the addition of a construct, “change readiness,” as well as refinements to constructs: organizational capacity (human capital, technical assistance, informal and formal leadership), local partnerships, and the importance of sustainability. The findings offer a data-informed theoretical framework that may be considered for use in evaluations of structural change interventions in complex and diverse counties.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 377-387 |
| Number of pages | 11 |
| Journal | Health Education and Behavior |
| Volume | 46 |
| Issue number | 3 |
| DOIs | |
| State | Published - Jun 1 2019 |
Funding
• I am looking for funding opportunities all the time. We received funding from [organization] . . . We’re looking at some smaller grants, a collective brands grant that has to do with more physical activity opportunities, the Lowe’s grant for the garden. We are currently about to partner with Home Depot and so we’re hoping they’re going to give us some resources. [Model Communities grantee] The authors would like to thank Wesley Epplin and Rachel Dombrowski for their invaluable contributions to the CPPW evaluation. The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: The CPPW evaluation was made possible by a cooperative agreement from the Centers for Disease Control and Prevention (Grant No.: 1U58DP002623-01) to the Public Health Institute of Metropolitan Chicago (PHIMC) and the Cook County Department of Public Health (CCDPH). The authors would also like to gratefully acknowledge support of the Centers for Disease Control and Prevention and ICF International to attend a CPPW writing workshop, and Jennifer Patashnick for her helpful guidance and expertise. The findings and conclusions in this article are those of the authors and do not necessarily represent the views of the U.S. Department of Health and Human Services, the Centers for Disease Control and Prevention, CCDPH and PHIMC.
Keywords
- community-based evaluations
- policy, systems, and environmental changes
- qualitative research
- structural change
- theory of change
ASJC Scopus subject areas
- Arts and Humanities (miscellaneous)
- Public Health, Environmental and Occupational Health
