A mixed-methods evaluation using effectiveness perception surveys, social network analysis, and county-level health statistics: A pilot study of eight rural Indiana community health coalitions

Abstract

Community health coalitions (CHCs) are a promising approach for addressing disparities in rural health statistics. However, their effectiveness has been variable, and evaluation methods have been insufficient and inconsistent. Thus, we propose a mixed-methods evaluation framework and discuss pilot study findings. CHCs in our pilot study partnered with Purdue Extension. Extension links communities and land grant universities, providing programming and support for community-engaged research. We conducted social network analysis and effectiveness perception surveys in CHCs in 8 rural Indiana counties during summer 2017 and accessed county-level health statistics from 2015-16. We compared calculated variables (i.e., effectiveness survey k-means clusters, network measures, health status/outcomes) using Pearson's correlations. CHC members' positive perceptions of their leadership and functioning correlated with interconnectedness in their partnership networks, while more centralized partnership networks correlated with CHC members reporting problems in their coalitions. CHCs with highly rated leadership and functioning developed in counties with poor infant/maternal health and opioid outcomes. Likewise, CHCs reporting fewer problems for participation developed in counties with poor infant/maternal health, poor opioid outcomes, and more people without healthcare coverage. This pilot study provides a framework for iterative CHC evaluation. As the evidence grows, we will make recommendations for best practices that optimize CHC partnerships to improve local health in rural areas.

Understanding the Development, Evaluation, and Sustainability of Community Health Networks Using Social Network Analysis: A Scoping Review

“…In 8 of the studies, SNA was used to support network development in a general sense. 26-33 Twenty-three of the studies used SNA more specifically to (a) map networks for improvement such as delivery of care (2); (b) correlate network attributes with related network survey data (18), including reputation, trust, and likelihood of collaboration; and (c) correlate network attributes with non-SNA derived outcomes such as hospital readmission (3). 34-56 The use of SNA to provide feedback to organizations regarding their development related to trust, existence of collaboration, and strength of ties among other characteristics, helped facilitate cross-sector collaborative efforts, decrease fragmentation of services and better address SDoH.…”

U.S. Cooperative Extension's response to substance misuse: A scoping review

“…A fifth record from the traditional literature focused on coalitionbased approaches as a promising approach for addressing disparities in rural health such as substance misuse (24). The sixth record was categorized as a Needs Assessment and described communityfocused needs assessment conducted as part of the PROMISE (Preventing Opioid Misuse in the SouthEast) initiative (25).…”