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. 2000 Aug;35(3):561–589.

The Kaiser Family Foundation Community Health Promotion Grants Program: findings from an outcome evaluation.

E H Wagner 1, T M Wickizer 1, A Cheadle 1, B M Psaty 1, T D Koepsell 1, P Diehr 1, S J Curry 1, M Von Korff 1, C Anderman 1, W L Beery 1, D C Pearson 1, E B Perrin 1
PMCID: PMC1089138  PMID: 10966086

Abstract

OBJECTIVES: To present results from an outcome evaluation of the Henry J. Kaiser Family Foundation's Community Health Promotion Grants Program (CHPGP) in the West, which represented a major community-based initiative designed to promote improved health by changing community norms, environmental conditions, and individual behavior in 11 western communities. METHODS: The evaluation design: 14 randomly assigned intervention and control communities, 4 intervention communities selected on special merit, and 4 matched controls. Data for the outcome evaluation were obtained from surveys, administered every two years at three points in time, of community leaders and representative adults and adolescents, and from specially designed surveys of grocery stores. Outcomes for each of the 11 intervention communities were compared with outcomes in control communities. RESULTS: With the exception of two intervention communities-a largely Hispanic community and a Native American reservation-we found little evidence of positive changes in the outcomes targeted by the 11 intervention communities. The programs that demonstrated positive outcomes targeted dietary behavior and adolescent substance abuse. CONCLUSIONS: Improvement of health through community-based interventions remains a critical public health challenge. The CHPGP, like other prominent community-based initiatives, generally failed to produce measurable changes in the targeted health outcomes. Efforts should focus on developing theories and methods that can improve the design and evaluation of community-based interventions.

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Selected References

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  1. Carleton R. A., Lasater T. M., Assaf A. R., Feldman H. A., McKinlay S. The Pawtucket Heart Health Program: community changes in cardiovascular risk factors and projected disease risk. Am J Public Health. 1995 Jun;85(6):777–785. doi: 10.2105/ajph.85.6.777. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Cheadle A., Psaty B., Wagner E., Diehr P., Koepsell T., Curry S., Von Korff M. Evaluating community-based nutrition programs: assessing the reliability of a survey of grocery store product displays. Am J Public Health. 1990 Jun;80(6):709–711. doi: 10.2105/ajph.80.6.709. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Curry S. J., Wagner E. H., Cheadle A., Diehr P., Koepsell T., Psaty B., McBride C. Assessment of community-level influences on individuals' attitudes about cigarette smoking, alcohol use, and consumption of dietary fat. Am J Prev Med. 1993 Mar-Apr;9(2):78–84. [PubMed] [Google Scholar]
  4. Dusenbury L., Falco M. Eleven components of effective drug abuse prevention curricula. J Sch Health. 1995 Dec;65(10):420–425. doi: 10.1111/j.1746-1561.1995.tb08205.x. [DOI] [PubMed] [Google Scholar]
  5. Farquhar J. W., Fortmann S. P., Flora J. A., Taylor C. B., Haskell W. L., Williams P. T., Maccoby N., Wood P. D. Effects of communitywide education on cardiovascular disease risk factors. The Stanford Five-City Project. JAMA. 1990 Jul 18;264(3):359–365. [PubMed] [Google Scholar]
  6. Farquhar J. W., Fortmann S. P., Maccoby N., Haskell W. L., Williams P. T., Flora J. A., Taylor C. B., Brown B. W., Jr, Solomon D. S., Hulley S. B. The Stanford Five-City Project: design and methods. Am J Epidemiol. 1985 Aug;122(2):323–334. doi: 10.1093/oxfordjournals.aje.a114104. [DOI] [PubMed] [Google Scholar]
  7. Farquhar J. W., Maccoby N., Wood P. D., Alexander J. K., Breitrose H., Brown B. W., Jr, Haskell W. L., McAlister A. L., Meyer A. J., Nash J. D. Community education for cardiovascular health. Lancet. 1977 Jun 4;1(8023):1192–1195. doi: 10.1016/s0140-6736(77)92727-1. [DOI] [PubMed] [Google Scholar]
  8. Fisher E. B., Jr The results of the COMMIT trial. Community Intervention Trial for Smoking Cessation. Am J Public Health. 1995 Feb;85(2):159–160. doi: 10.2105/ajph.85.2.159. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Koepsell T. D., Martin D. C., Diehr P. H., Psaty B. M., Wagner E. H., Perrin E. B., Cheadle A. Data analysis and sample size issues in evaluations of community-based health promotion and disease prevention programs: a mixed-model analysis of variance approach. J Clin Epidemiol. 1991;44(7):701–713. doi: 10.1016/0895-4356(91)90030-d. [DOI] [PubMed] [Google Scholar]
  10. Koepsell T. D., Martin D. C., Diehr P. H., Psaty B. M., Wagner E. H., Perrin E. B., Cheadle A. Data analysis and sample size issues in evaluations of community-based health promotion and disease prevention programs: a mixed-model analysis of variance approach. J Clin Epidemiol. 1991;44(7):701–713. doi: 10.1016/0895-4356(91)90030-d. [DOI] [PubMed] [Google Scholar]
  11. Kottke T. E., Puska P., Salonen J. T., Tuomilehto J., Nissinen A. Projected effects of high-risk versus population-based prevention strategies in coronary heart disease. Am J Epidemiol. 1985 May;121(5):697–704. doi: 10.1093/aje/121.5.697. [DOI] [PubMed] [Google Scholar]
  12. Luepker R. V., Murray D. M., Jacobs D. R., Jr, Mittelmark M. B., Bracht N., Carlaw R., Crow R., Elmer P., Finnegan J., Folsom A. R. Community education for cardiovascular disease prevention: risk factor changes in the Minnesota Heart Health Program. Am J Public Health. 1994 Sep;84(9):1383–1393. doi: 10.2105/ajph.84.9.1383. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Marks J. S., Hogelin G. C., Gentry E. M., Jones J. T., Gaines K. L., Forman M. R., Trowbridge F. L. The behavioral risk factor surveys: I. State-specific prevalence estimates of behavioral risk factors. Am J Prev Med. 1985 Nov-Dec;1(6):1–8. [PubMed] [Google Scholar]
  14. Mittelmark M. B., Luepker R. V., Jacobs D. R., Bracht N. F., Carlaw R. W., Crow R. S., Finnegan J., Grimm R. H., Jeffery R. W., Kline F. G. Community-wide prevention of cardiovascular disease: education strategies of the Minnesota Heart Health Program. Prev Med. 1986 Jan;15(1):1–17. doi: 10.1016/0091-7435(86)90031-9. [DOI] [PubMed] [Google Scholar]
  15. Murray D. M. Design and analysis of community trials: lessons from the Minnesota Heart Health Program. Am J Epidemiol. 1995 Sep 15;142(6):569–575. doi: 10.1093/oxfordjournals.aje.a117677. [DOI] [PubMed] [Google Scholar]
  16. Psaty B. M., Cheadle A., Curry S., McKenna T., Koepsell T. D., Wickizer T., VonKorff M., Diehr P., Perrin E. B., Wagner E. H. Sampling elderly in the community: a comparison of commercial telemarketing lists and random digit dialing techniques for assessing health behaviors and health status. Am J Epidemiol. 1991 Jul 1;134(1):96–106. doi: 10.1093/oxfordjournals.aje.a115997. [DOI] [PubMed] [Google Scholar]
  17. Puska P., Nissinen A., Tuomilehto J., Salonen J. T., Koskela K., McAlister A., Kottke T. E., Maccoby N., Farquhar J. W. The community-based strategy to prevent coronary heart disease: conclusions from the ten years of the North Karelia project. Annu Rev Public Health. 1985;6:147–193. doi: 10.1146/annurev.pu.06.050185.001051. [DOI] [PubMed] [Google Scholar]
  18. Susser M. The tribulations of trials--intervention in communities. Am J Public Health. 1995 Feb;85(2):156–158. doi: 10.2105/ajph.85.2.156. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Syme S. L. Strategies for health promotion. Prev Med. 1986 Sep;15(5):492–507. doi: 10.1016/0091-7435(86)90026-5. [DOI] [PubMed] [Google Scholar]
  20. Tarlov A. R., Kehrer B. H., Hall D. P., Samuels S. E., Brown G. S., Felix M. R., Ross J. A. Foundation work: the health promotion program of the Henry J. Kaiser Family Foundation. Am J Health Promot. 1987 Fall;2(2):74–80. doi: 10.4278/0890-1171-2.2.74. [DOI] [PubMed] [Google Scholar]
  21. Wickizer T. M., Von Korff M., Cheadle A., Maeser J., Wagner E. H., Pearson D., Beery W., Psaty B. M. Activating communities for health promotion: a process evaluation method. Am J Public Health. 1993 Apr;83(4):561–567. doi: 10.2105/ajph.83.4.561. [DOI] [PMC free article] [PubMed] [Google Scholar]
  22. Wickizer T. M., Wagner E., Cheadle A., Pearson D., Beery W., Maeser J., Psaty B., VonKorff M., Koepsell T., Diehr P. Implementation of the Henry J. Kaiser Family Foundation's Community Health Promotion Grant Program: a process evaluation. Milbank Q. 1998;76(1):121–147. doi: 10.1111/1468-0009.00081. [DOI] [PMC free article] [PubMed] [Google Scholar]

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