One of the public health programs which have been evaluated is Alabama Racial and Ethnic Approaches to Community Health (REACH 2010) (Ryan, 2018). The Alabama REACH 2010 project was aimed at reducing and eliminating racial differences in cervical and breast cancer in Black and White women in Alabama counties (Sayed et al., 2019; Wynn-Wallace, 2016). To accomplish its goals and objectives, Alabama REACH 2010 established a community group tasked with designing, implementing, and evaluating community-related approaches needed to address differences in cancer prevalence.
The First phase of Alabama REACH 2010 commenced in 1999 and comprised of a planning period that lasted for one year. Phase I was aimed at building a coalition and actively engaging it in all aspects of establishing a community action plan intended to guide the work of the group in phase II. The work carried out in phase II included the execution of demonstration projects and evaluation. In Phase I of the project, the planners set four objectives to be attained. The first objective involved the establishment of a collation comprising of state institutions, academia, and community members. Second, the planners ensured that community members are equipped with the knowledge and skills needed to participate in coalition activities. Third, the community needs assessment was conducted to determine differences in cancer screening. Lastly, the community action plan was developed and focused on the final goal of decreased and elimination of racial disparities in cervical and breast cancer.
The process evaluation of Alabama REACH 2010 was focused on the four objectives outline above (Nagy et al., 2008). The evaluators and stakeholders comprised of members of the Alabama Partnership for Cancer Prevention and Control Among the Underserved, community health advisors, faith-based and community-based organizations, and115 African American women. The results of the process evaluation revealed that the achievement of the Alabama REACH 2010 project is attributed to evaluative feedback. The results further showed that process evaluation leads to the development of a function community group, improved community capacity, robust community needs assessment, and development of an effective community plan. Through process evaluation, a clear roadmap was developed to guide the progress and implementation of the project.
CDC REACH 2014
REACH 2014 program was aimed at reducing health disparities (Bialek et al., 2017; CDC, 2018). Specifically, since its inception in 1999, REACH programs have focused on decreasing chronic diseases for many racial and ethnic groups in communities with a high prevalence of chronic illnesses. The reduction of these diseases is achieved through the promotion of healthy behaviors and management of the conditions in minority groups, which are most affected (CDC, 2017). Improved health is achieved through linking clinics to community-related programs to enable the target population to manage chronic conditions, enhanced support for smoke cessation, increased support for physical activity, and enhanced healthy diet options (CDC, n.d.; CDC, 2020).
The legacy of the REACH 2014 program is manifested through improved access to healthy foods and beverages by more than 2.9 million individuals and more than 300,000 people benefitting from smoking cessation interventions. Additionally, more than 800,000 individuals have been linked to local chronic disease programs and more than 1.4 million people got access to physical activity programs.
The primary stakeholders in the CDC REACH 2014 program include the CDC and community members derived from the minority racial and ethnic groups who are a high risk of developing chronic diseases. Local program evaluation of the CDC REACH 2014 program showed that the target audience had achieved success at altering local environments to enhance healthy behaviors among the minority groups with a high prevalence of chronic conditions (CDC, 2017). Some of the positive outcomes associated with the REACH 2014 program include increased access to healthier foods, smoke-free environments, and health services (CDC, 2017).
Evaluation of the further revealed that that the target audience should be involved in all the stages of the program, from design to evaluation (CDC, 2017). Additionally, the results revealed the need to partner with organizations or individuals with community interest at heart. Finally, it was revealed that adapting a program to community practices, language, and culture ensures its success.
Ways in Which the Evaluation Results Can be Used to Improve the Program
Based on the results of the evaluation conducted on the Alabama REACH 2010, improvement of the program can be accomplished through the development and implementation of process evaluation on time, the commitment of a community-based participatory research team, and the provision of adequate resources and personnel. It is also vital to ensure that stakeholders' involvement and funds are secured before the onset of the program. The community should even own the program to ensure that there is continued support. The results of the evaluation of the CDC REACH 2014 program reveals that the program can be improved through continued community support and partnership with organizations keen to achieve improved health in the at-risk minority population (Faan & Faan, 2019; Leffers et al., 2018).
Explanation of a More Effective Program Evaluation
The evaluation of Alabama REACH 2010 was more effective than that of REACH 2014 because it targeted the implementation phase of the project rather than the end of the program. When the effectiveness of the implementation is determined, improvements to the program can be achieved, leading to the accomplishment of its goals. Conversely, assessing the outcomes as seen in REACH 2014, cannot lead to the improvement of the current program.
Bialek, R., Beitsch, L. M., & Moran, J. W. (2017). Solving population health problems through collaboration. Taylor & Francis.
CDC. (n.d.). Making healthy living easier. https://www.cdc.gov/nccdphp/dch/pdfs/00-making-life-easier-reach.pdf
CDC. (2017). REACH Overview Factsheet. https://www.cdc.gov/nccdphp/dnpao/state-local-programs/reach/pdf/REACH-overview-2017-508.pdf
CDC. (2018). REACH 2014. Centers for Disease Control and Prevention. https://www.cdc.gov/nccdphp/dnpao/state-local-programs/reach/2014/index.html
CDC. (2020). Division of nutrition, physical activity, and obesity at a glance | cdc. https://www.cdc.gov/chronicdisease/resources/publications/aag/dnpao.htm
Faan, M. S., RN Dsn, & Faan, J. L., RN PhD. (2019). Public health nursing e-book: Population-centered health care in the community. Elsevier Health Sciences.
Leffers, J. M., Audette, J. G., Hardwick, K. S., & Cleve, W. V. (2018). International partnerships for strengthening health care workforce capacity: Models of collaborative education. Frontiers Media SA.
Nagy, M. C., Johnson, R. E., Vanderpool, R. C., Fouad, M. N., Dignan, M., Wynn, T. A., ... & Person, S. D. (2008). Process evaluation in action: lessons learned from Alabama REACH 2010. Journal of Health Disparities Research and Practice, 2(1), 6.
Ryan, C. (2018). The alabama project: Representing the complexity of cancer survivorship in words and images. Rhetoric of Health & Medicine, 1(3), 372-395.
Sayed, S., Ngugi, A. K., Mahoney, M. R., Kurji, J., Talib, Z. M., Macfarlane, S. B., Wynn, T. A., Saleh, M., Lakhani, A., Nderitu, E., Agoi, F., Premji, Z., Zujewski, J. A., & Moloo, Z. (2019). Breast Cancer knowledge, perceptions and practices in a rural Community in Coastal Kenya. BMC Public Health, 19(1), 180. https://doi.org/10.1186/s12889-019-6464-3
Wynn-Wallace, T. A. (2016). Using community feedback to improve community interventions: Results from the deep south network for cancer control project. Family & Community Health, 39(4), 234-241. https://doi.org/10.1097/FCH.0000000000000101
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