Using evaluability assessment to assess local community development health programmes: a Scottish case-study

Abstract

BackgroundEvaluation of the potential effectiveness of a programme’s objectives (health or otherwise) is important in demonstrating how programmes work. However, evaluations are expensive and can focus on unrealistic outcomes not grounded in strong theory, especially where there is pressure to show effectiveness. The aim of this research was to demonstrate that the evaluability assessment (a cost-effective pre-evaluation tool that primarily gives quick, constructive feedback) can be used to help develop programme and outcome objectives to improve programmes while they run and to assist in producing more effective evaluations. This was done using the example of a community development programme aiming to improve health and reduce health inequalities in its target population.MethodsThe setting was Glasgow, Scotland, UK and focused on the Health Issues in the Community programme. Data were collected from documents and nine individual stakeholder interviews. Thematic analysis and a realist approach were used to analyse both datasets and, in conjunction with a workshop with stakeholders, produce a logic model of the programme theory and related evaluation options to explore further.ResultsFive main themes emerged from the analysis: History; Framework; Structure and Delivery of the Course; Theory of Action; and Barriers to Delivery and Successful Outcomes. These themes aided in drafting the logic model which revealed they key programme activities (e.g. facilitating group learning) and 23 potential outcomes. The majority of these outcomes (16) were deemed to be short-term outcomes (more easily measured within the timeframe of an individual being involved in the programme) e.g. increased self-esteem or awareness of individual/community health. The remaining 6 outcomes were deemed longer-term and included outcomes such as increased social capital and individual mental health and wellbeing.ConclusionsWe have shown that the evaluability assessment tool can be applied to the evaluation of community health programmes, providing short- and long-term outcomes that could be evaluated to demonstrate effectiveness and avoid unnecessary or poorly designed full-scale evaluations. This type of pre-evaluation method is already a useful resource for national policy evaluations, but could be a valuable evaluation tool for other regional or community health programmes.

Advancing complexity science in healthcare research: the logic of logic models

“…The utility of logic models has been a frequent topic of BMC Medical Research Methodology [ 8 , 11 , 17 , 18 ]. Addressing the aforementioned debate, Greenwood et al question whether logic models can represent the dynamics of complex interventions that adapt to context, stating that “no matter how sophisticated, a logic model alone is not sufficient, as complexity cannot be understood purely through qualitative description” [ 11 ].…”

South West Food Community: understanding systemic change, and its associated challenges and successes, among food security projects

“…45 The themes identified in this study are consistent with other community development evaluation studies in Tasmania (Australia), North India and Scotland that identified effective partnerships and found that government funding led to successful outcomes for community food security initiatives. [46][47][48] Adams and Taylor (2019) found that collaboration was essential for effective local food systems and that an innovative, diverse response was required to address community food security. 46 The authors recommended that all levels of government should preference social procurement contracts that enhance local food systems.…”

“…47 Limited time; lack of participation; lack of support from the community, local organisations and government; and limited resources were reported as factors that reduced the effectiveness of community development programs. 47,48 To counter these issues, the study reported a need to increase resourcing and service provision to enable nutritious food access for at-risk population groups. 46 A possible reason why initiatives in our study did not possess desirable characteristics was due to bureaucracy within organisations, particularly at a government level.…”

“…This is supported by an evaluation of a Scottish community development health program that identified a lack of organisational and governmental support due to organisational restructuring, the hierarchy of stakeholders, the differences in stakeholders expectations and the misinterpretation of program aims as key contributors. 48 In addition, markers of success included organisational and governmental support through funding and time led to successful intermediate outcomes that translated to long-term outcomes. 48 Our study also highlighted the importance of the volunteers to support initiative changes.…”

“…48 In addition, markers of success included organisational and governmental support through funding and time led to successful intermediate outcomes that translated to long-term outcomes. 48 Our study also highlighted the importance of the volunteers to support initiative changes. We found employed staff reported a lack of time to support additional voluntary duties even if desired.…”