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. (December 2019)

• Record Type: Journal Article
• Authors: Ken-Opurum, Jennifer; Lynch, Krystal; Vandergraff, Donna; Miller, Douglas K.; Savaiano, Dennis A.
• Is Part Of: Evaluation and program planning. Volume 77(2019)
• Publication Date: 2019-12
• Subjects: BRFSS Behavioral Risk Factor Surveillance System -- CHC(s) community health coalition(s) -- CoHealth county-level health statistics -- CSAS Coalition Self-Assessment Survey -- LF one of the variables resulting from a cluster analysis on the CSAS, describing CHC members' positive perceptions of their leadership and internal functioning -- NEP Nutrition Education Program -- PROB one of the variables resulting from a cluster analysis on the CSAS, describing CHC members' problems for participation -- PSE policy, system, and environment -- SNA social network analysis -- SNAP-Ed Supplemental Nutrition Assistance Program-Education; Behavioral risk factor surveillance system -- Community health -- Health promotion -- Multilevel assessment -- Program evaluation -- Rural health; Health planning -- Periodicals; Medical care -- Evaluation -- Periodicals; 362.1068
• DOI: 10.1016/j.evalprogplan.2019.101709
• Languages: English
• ISSNs: 0149-7189

Abstract

Highlights: We developed and piloted a community health coalition (CHC) evaluation framework. CHCs with greater interconnectedness reported better leadership and functioning. Centralized CHCs reported more problems for member participation. Personal relationships were more favorable than formal connections for CHC outcomes. CHCs responding to crises had greater perceived effectiveness than chronic disease CHCs. 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.