No abstract

African Americans have a higher prevalence of hypertension and poorer cardiovascular and renal outcomes than white Americans. The objective of this study was to determine whether a telephonic nurse disease management (DM) program designed for African Americans is more effective than a home monitoring program alone to increase blood pressure (BP) control among African Americans enrolled in a national health plan.A prospective randomized controlled study (March 2006-December 2007 was conducted, with 12 months of follow-up on each subject. A total of 5932 health plan members were randomly selected from the population of self-identified African Americans, age 23 and older, in health maintenance organization plans, with hypertension; 954 accepted, 638 completed initial assessment, and 485 completed follow-up assessment.The intervention consisted of telephonic nurse DM (intervention group) including educational materials, lifestyle and diet counseling, and home BP monitor vs. home BP monitor alone (control group). Measurements included proportion with BP < 120=80, mean systolic BP, mean diastolic BP, and frequency of BP selfmonitoring.Results revealed that systolic BP was lower in the intervention group (adjusted means 123.6 vs. 126.7 mm Hg, P ¼ 0.03); there was no difference for diastolic BP. The intervention group was 50% more likely to have BP in control (odds ratio [OR] ¼ 1.50, 95% confidence interval [CI] 0.997-2.27, P ¼ 0.052) and 46% more likely to monitor BP at least weekly (OR 1.46, 95% CI 1.07-2.00, P ¼ 0.02) than the control group.A nurse DM program tailored for African Americans was effective at decreasing systolic BP and increasing the frequency of self-monitoring of BP to a greater extent than home monitoring alone. Recruitment and program completion rates could be improved for maximal impact. (Population Health Management 2010;13:65-72)

Objectives To examine the process of community-campus engagement in an initiative developed to build evaluation capacities of community-based organizations (CBOs). Methods Evaluability assessment, capacity-building, self administered surveys and semi-structured interviews were conducted from 2004 to 2007 and analyzed through transcript assessment and SPSS to identify trends, relationships and capacity changes over time. Results Evaluability assessment identified CBO strengths in program planning and implementation and challenges in measurable objective development, systematic use of mixed methods, data management and analysis. Evaluability assessment informed evaluation capacity-building (ECB) trainings, teleconferences and webinars that resulted in statistically significant improvements in evaluation knowledge, skills, and abilities. Post-initiative interviews indicated CBO preferences for face-to-face training in logic model development, mixed method data collection and analysis. Conclusion This report illustrates the use of mixed methods to plan, implement and evaluate a model to catalyze CBOs systematic assessment of prevention initiatives and considerations in evaluation capacity-building.

Community-based organizations (CBOs) have the potential to promote and sustain health, prevent disease, and address health disparities, but many lack the capacity to do so. An assessment of the 20 CBOs receiving supplemental grant funding from the Pfizer Foundation Southern HIV/AIDS Prevention Initiative indicated a high level of knowledge for developing goals and objectives (mean score = 3.08 on a scale of 0 (none) to 4 (extensive)) and high self-assessed abilities to conduct six of 20 specific intervention activities, including the development of community relationships and coalitions. Lower knowledge and skill levels were observed for intervention evaluation. While CBOs of this Initiative have established prerequisite abilities, they have self-acknowledged needs for technical assistance to maximize HIV/AIDS prevention capacity.

The catalytic potential of community-based organizations to promote health, prevent disease, and address racial, ethnic, and socio-economic disparities in local communities is well recognized. However, many CBOs, particularly, small- to medium-size organizations, lack the capacity to plan, implement, and evaluate their successes. Moreover, little assistance has been provided to enhance their capacity and the effectiveness of technical assistance to enhance capacity is likewise limited. A unique private-academic partnership is described that simultaneously conducted program evaluation and addressed the capacity needs of 24 CBOs funded by the Pfizer Foundation Southern HIV/AIDS Prevention Initiative. Assessments of key program staff members at 12 and 18 months after the initial cross-site program assessment survey indicated a significant improvement in the CBOs’ knowledge, skills, and abilities and a substantial reduction in their technical assistance needs for HIV/AIDS prevention. Full participation of CBOs in technical assistance and a concurrent empowerment evaluation framework were necessary to enhance prevention capacity.