Box 2. Change Strategies and Evaluation Methods, by Ecological Level

Level of HEART Intervention	Evaluation Method
1. Individual: HEART participant	Pre- and postparticipant survey questionnaire to evaluate the impact of the MiCMiC 4-month intervention for the different study cohorts. Survey covers  various heart-health domains including knowledge, beliefs, attitudes, perceptions and intentions, self-efficacy, social norms and outcomes such as blood pressure, BMI, waist circumference, dietary behaviors and 3-minute step test for heart rate.
2. Interpersonal: promotoras, family, friends, social networks	Pre- and postsurvey questionnaire as in level 1.
	Reflection notes and focus groups with the promotoras during pilot and cohort intervention.
3. Organizational: HEART Partners: Community Health Academy and Leadership Council, YWCA, Parks and Recreation Department, University of Texas-El Paso, University of Texas School of Public Health, Centro San Vicente, El Paso Community College	HEART partnership self-assessment instrumenta to assess effectiveness of Community Health Academy and Leadership Council meetings, outreach, trainings, and relationship with elected officials, as well as satisfaction with Community Health Academy and Leadership Council partnership development and strategic planning.
	Reflection notes and discussion session for YWCA and Department of Parks and Recreation.
	Community Health Academy and Leadership Council strategic planning and development of vision and mission statements.
	Community Health Academy and Leadership Council meetings' minutes discussion and self-reflection.
4. Community	Community telephone survey to test the impact of MiCMiC at the community level. Pre- and postintervention telephone survey to be conducted in intervention community and a control community. The survey evaluates perception and use of community health workers, perception of community resources for exercise and healthy living, dietary behavior, diabetes, hypertension, drinking, smoking, and basic demographics.
	HEART participant sign-up sheet available at final ceremony to identify leaders to continue heart-healthy activities in the community, post-intervention (ie, walking groups, aerobics activities, cooking clubs).
5. Policy: policy makers	Development of a policy agenda for HEART and documentation of actions carried out on that agenda.

^aAdapted from the instrument developed by Butterfoss (22).