Dose as a Tool for Planning and Implementing Community-Based Health Strategies

Kuo, Elena S.; Harner, Lisa T.; Frost, Madeline C.; Cheadle, Allen; Schwartz, Peter H.

doi:10.1016/j.amepre.2018.01.010

“…The purpose of this study was to use intensity scoring to assess whether higher intensity MCIs implemented as part of a statewide initiative were associated with improved PA and reduced sedentary time among youth (dependent variables). Similar to previous research, 25,26,29 we found a statistically signi cant relationship between higher MCI intensity scores and increased PA and decreased sedentary behavior.…”

Section: Discussionsupporting

confidence: 91%

“…Moreover, while funders and other stakeholders want to see population-level health and behavior improvements (e.g., reduced obesity, increased youth physical activity), these changes may not be detectable in the short-term [23,24]. Efforts to assess strategies and their likely positive impact in the long-term are warranted, and have been increasingly explored [14,[25][26][27][28][29] to [14,[25][26][27][28][29]. Cheadle et.…”

Section: Introductionmentioning

confidence: 99%

Association between multi-component initiatives and physical activity-related behaviors: interim findings from the Healthy Schools Healthy Communities Initiative

Calise

¹

,

Spitzer

²

,

Ruggiero

³

et al. 2020

Preprint

0

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Background: Little is known about the intensity of multi-component initiatives (MCI) inclusive of any combination of programs, practices, policies, and environmental changes (P3E) on youth behaviors. Methods: The Healthy Schools Healthy Communities (HSHC) initiative worked to increase access to PA opportunities as part of 33 MCIs targeting school districts and respective communities. The purpose of this study was to assess whether MCIs with higher scoring PA-related strategies were associated with improved PA and sedentary behaviors among youth. PA-related interventions were assigned point values based on three characteristics: 1) purpose of initiative); 2) duration; and 3) reach. An overall composite score of all activities was calculated for each school district. Multivariate longitudinal regressions were applied, controlling for measurement period, Cohort, and district enrollment. Results: P3E scores ranged from 0.3 to 3.0 with 20% considered “higher-scoring” (score > 2.1) and 47% considered “lower-scoring” ( < 1.2 ). Average composite district P3E scores more than tripled over the evaluation period, rising from 14.8 in the first grant year to 32.1 in year 2, 41.1 in year 3, and 48.1 in year 4. For each additional point increase in average composite district P3E intensity score, the number of days per week that students reported being physically active for at least 60 minutes increased by 0.010 (p<0.01). For each additional point increase in district P3E intensity score, the number of hours per weekday that students reported engaging in screen time activities decreased by 0.006 hours (p<0.5). Conclusions: MCIs are difficult to evaluate given the variations within which they are implemented. Findings from this study suggest the value of a systematic scoring approach in assessing MCIs. In addition to tracking intensity over time, scoring can provide justification for, or against, an individual activity and ways to increase the likelihood of the MCI impacting population-health outcomes.

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“…Interventions focusing on just one level may not be sufficiently powerful to achieve population-level change. Kuo, Harner, Frost, Cheadle, and Schwartz (2018) share how the concept of dose, which combines reach and intensity, was useful to coalitions in selecting and refining their strategies for maximum impact.…”

Section: Discussionmentioning

confidence: 99%

Evaluation Methods Commonly Used to Assess Effectiveness of Community Coalitions in Public Health: Results From a Scoping Review

Kegler

¹

,

Halpin²,

Butterfoss

³

2020

New Drctns Evaluation

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Community coalitions are well established as an important strategy for addressing public health problems through the lens of health equity, social determinants of health, and/or a social ecologic perspective. After almost three decades of practice and research on community‐based collaborative approaches, a large number of evaluations have been conducted to examine the processes of coalition formation, approaches to creating community change, and whether intermediate and longer‐term outcomes have been achieved. This chapter reports the results of a scoping review of the methods commonly used to evaluate community coalitions. English‐language articles were identified through a search of keywords, including community coalitions and evaluation published in the PubMed database between 2000 and 2018. Only outcome evaluations were included for a total of fifty‐five eligible papers. Two coders abstracted the following domains: public health topic, number of coalitions, framework or theory, study design, data collection methods, temporality, and types of outcomes (i.e., behavioral or health, community change, community capacity). Strategies for attributing observed outcomes to coalitions also were assessed. Findings suggest that the same challenges which limited the field a decade ago remain. Community changes were documented most often, with no behavioral or health outcomes. Studies that evaluated behavioral or health outcomes most commonly evaluated a single program, with limited or no examination of how the coalition(s) influenced program effectiveness. Current methods are adequate for assessing community changes and community capacity outcomes and evaluating specific intervention strategies. The two real stumbling blocks are documenting whether complex and synergistic multi‐sectoral community change leads to population‐level behavioral and health outcomes and, then, parceling out the added value of a coalition approach over other approaches to creating community change.

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“…There was also a negative correlation between weekend sedentary hours per day and P3E intensity score, but it was not significant (p = 0.098). Building on the RE-AIM Framework 28 and previous research, 25,26,29 higher intensity activities can lead to improved health outcomes. This study expanded upon the HCS by suggesting the number of Understanding the mechanisms of effects can help stakeholders and their funders assess whether a package of interventions is performing in the way it is intended along the full range of its implementation, rather than simply an evaluation of its ultimate impact.…”

Section: Relationship Between P3e Scores and Outcomesmentioning

confidence: 94%

“…In recent years, efforts to assess the impact of MCIs have expanded (17,(25)(26)(27)(28)(29).Largely building on the RE-AIM (reach, effectiveness, adoption, implementation, and maintenance) framework (30),many evaluations have assessed a combination of attributes among all strategies within an initiative (17,(25)(26)(27)(28)(29). Cheadle et.…”

mentioning

confidence: 99%

Association between multi-component initiatives and physical activity-related behaviors: interim findings from the Healthy Schools Healthy Communities Initiative

Calise

¹

,

Spitzer

²

,

Ruggiero

³

et al. 2019

Preprint

0

View full text Add to dashboard Cite

Background: Little is known about the intensity of multi-component initiatives (MCI) inclusive of any combination of programs, practices, policies, and environmental changes (P3E) on youth behaviors. Methods: The Healthy Schools Healthy Communities (HSHC) initiative worked to increase access to PA opportunities as part of 33 MCIs targeting school districts and respective communities. The purpose of this study was to assess whether MCIs with higher scoring PA-related strategies were associated with improved PA and sedentary behaviors among youth. PA-related interventions were assigned point values based on three characteristics: 1) purpose of initiative); 2) duration; and 3) reach. An overall composite score of all activities was calculated for each school district. Multivariate longitudinal regressions were applied, controlling for measurement period, Cohort, and district enrollment. Results: P3E scores ranged from 0.3 to 3.0 with 20% considered “higher-scoring” (score > 2.1) and 47% considered “lower-scoring” ( < 1.2 ). Average composite district P3E scores more than tripled over the evaluation period, rising from 14.8 in the first grant year to 32.1 in year 2, 41.1 in year 3, and 48.1 in year 4. For each additional point increase in average composite district P3E intensity score, the number of days per week that students reported being physically active for at least 60 minutes increased by 0.010 (p<0.01). For each additional point increase in district P3E intensity score, the number of hours per weekday that students reported engaging in screen time activities decreased by 0.006 hours (p<0.5). Conclusions: MCIs are difficult to evaluate given the variations within which they are implemented. Findings from this study suggest the value of a systematic scoring approach in assessing MCIs. In addition to tracking intensity over time, scoring can provide justification for, or against, an individual activity and ways to increase the likelihood of the MCI impacting population-health outcomes.

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Dose as a Tool for Planning and Implementing Community-Based Health Strategies

Abstract: This article is part of a supplement entitled Building Thriving Communities Through Comprehensive Community Health Initiatives, which is sponsored by Kaiser Permanente, Community Health.

Cited by 6 publications

References 11 publications

Association between multi-component initiatives and physical activity-related behaviors: interim findings from the Healthy Schools Healthy Communities Initiative

Association between multi-component initiatives and physical activity-related behaviors: interim findings from the Healthy Schools Healthy Communities Initiative

Evaluation Methods Commonly Used to Assess Effectiveness of Community Coalitions in Public Health: Results From a Scoping Review

Association between multi-component initiatives and physical activity-related behaviors: interim findings from the Healthy Schools Healthy Communities Initiative

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