Assessment of Nutrition and Physical Activity Policy in St. Louis Childcare Settings
CPHSS partnered with the Center for Diabetes Translation research to identify facilitators and barriers to the implementation of evidence-based nutrition and physical activity interventions in childcare settings.
Assessment of Needs and Assets among the Birth-to-21 Population in Greater St. Louis
In collaboration with the United Way of Greater St. Louis and Dr. Jason Purnell of the Brown School, CPHSS conducted an assessment of needs, services, and resources among the Birth-to-21 population in the Greater St. Louis area. The analysis was conducted based on seven Birth-to-21 market areas: 1) Basic Needs and Financial Stability, 2) Child Welfare, 3) Disabilities, 4) Early Childhood Education, 5) Health, 6) Mental Health and Substance Abuse, and 7) Youth Development. The results were used in United Way’s strategic planning process, as well as shared with community stakeholders for use in their projects.
Best Practices Evaluation
In 1999, the Centers for Disease Control and Prevention published Best Practices for Comprehensive Tobacco Control Programs (Best Practices), the first evidence-based set of recommendations on how states should develop and fund comprehensive tobacco control programs. Starting in 2001, CPHSS conducted an evaluation which aimed to: 1) develop a comprehensive picture of a state's tobacco control program; 2) examine the effects of political, organizational, and financial factors on state tobacco control programs; and 3) learn how states used Best Practices. Evaluation results were used to help inform the development of a 2007 update to Best Practices.
Community Capacity Assessment Project
In 2007, CPHSS was contracted to conduct a network analysis of St. Louis cancer services providers by the Program for the Elimination of Cancer Disparities (PeCAD) at the Siteman Cancer Center.
The two primary objectives of the Community Capacity Assessment Project were to: 1) describe the network of cancer support service providers in the St. Louis Metropolitan area; and 2) examine how the agencies interact and collaborate with each other. The results of this project will inform PeCAD’s strategic planning efforts to help strengthen the network and reduce cancer disparities in St. Louis.
Communities Putting Prevention to Work Project Evaluation
The U.S. Department of Health and Human Services' Communities Putting Prevention to Work
(CPPW) Initiative supported community public health efforts to improve nutrition, increase physical activity, reduce obesity, and decrease tobacco use. In 2010, the St. Louis County Department of Health (DOH) received one of 50 CPPW grants. In collaboration with a team from the Saint Louis University School of Public Health, CPHSS served as the main evaluator of the St. Louis County CPPW project from 2010-2012. A comprehensive evaluation plan was developed to examine both process and outcome measures. Specifically, CHPSS evaluated change across four main domains: policy change, systems change, environmental change, and behavioral and social norm change. As part of the evaluation, the strength, contribution, and expansion of the St. Louis County Tobacco Control Network was also examined using data collected from a social network analysis survey and key informant interviews. View Evaluation Products here
Evaluation of the CDC Office on Smoking and Health's National Network Initiative
The National Networks for Tobacco Control and Prevention
initiative was first funded in 2001 to develop networks with a national scope to address tobacco-related disparities in priority populations (African American; American Indian/Alaskan Native; Asian American/Pacific Islander; Hispanic/ Latino; low socio-economic; lesbian, gay, bisexual, and transgender). The initiative had three rounds of funding, the most recent of which began in 2008 and lasts for five years, continuing the development of the six National Networks. CPHSS conducted an evaluation at the beginning of this round of funding to evaluate progress made by the networks on the following activities: 1) Maintaining and strengthening a national tobacco control network; 2) Facilitating learning and information sharing between Network participants, CDC OSH, states, and other national tobacco control partners; 3) Assessing the impact of tobacco on the population as well as gaps in data, interventions, and/or evaluation; 4) Identifying strategies and methodology for evaluation progress and performance; and 5) Participating in central website development and maintenance.
Healthy & Active Communities Initiative Evaluation
CPHSS served as the external evaluator for this Missouri Foundation for Health initiative from 2008 to 2015. Initiative grantees were funded to combat obesity through various innovative methods, including direct programming, the built environment, advocacy, and policy change.
Heart Disease and Stroke Prevention Policy Analysis
In collaboration with the CDC’s Division for Heart Disease and Stroke Prevention, CPHSS is helping to develop a system to assess policies related to heart disease and stroke prevention and the extent to which states have enacted evidence-based laws that address chronic disease prevention. To assess the extent that
existing state laws are evidence-based, the HDSP team and DHDSP developed the Quality
and Impact of Component (QuIC) Evidence Assessment method. This method
evaluates the best available evidence for a component from a public health
policy and categorizes it along a continuum of evidence strength. In 2014, the HDSP team used QuIC to identify and assess the evidence for 14 components of community health worker policy. The results of this assessment are summarized in the Policy Evidence Assessment Report: Community Health Worker Policy Components. This report is the first in a series of Policy Evidence Assessment Reports, which will review the evidence for policy options -- including those related to workplace health promotion and patient-centered medical homes, among others -- to improve chronic disease outcomes.
Implementation of Evidence-based Guidelines by State Tobacco Control Programs
In collaboration with the National Association of Chronic Disease Directors (NACDD)
and the CDC’s Office on Smoking and Health (CDC OSH)
, CPHSS conducted a multi-state evaluation the 2007 Best Practices for Comprehensive Tobacco Control Programs
from 2009-2010. The research team traveled to seven states and Washington, D.C. in order to conduct in-depth, semi-structured interviews with state tobacco control partners. The goal of the project was to examine how state tobacco control partners were using the 2007 Best Practices for Comprehensive Tobacco Control Programs and other evidence-based guidelines. The evaluation findings were disseminated to states, the CDC, and other stakeholders through individual state profiles, and aggregate data was presented at national conferences and meetings. The findings will be used to inform future efforts aimed at facilitating the use of evidence-based guidelines.
Mapping National Tobacco Control Leadership and Activities
The U.S. Department of Health and Human Services (DHHS) has overall responsibility for planning, guiding, and funding tobacco control and research activities for the United States. These planning and funding activities are carried out within the various DHHS agencies. In order to develop and carry out a coordinated set of tobacco control plans, the staff in the DHHS agencies must be able to communicate with one another, coordinate activities, build informal and formal partnerships, and work towards a common goal of reducing the health burden of tobacco. The primary aim of the DHHS Mapping Project was to create a map of the tobacco control leadership within DHHS. Partnering with the DHHS, NIH, CDC, and Battelle, CPHSS led the data collection and analysis efforts for this project.
Midwest Casino Study
Rich scientific evidence shows that restaurants and bars do not experience adverse economic effects when smokefree laws are enacted. However, less evidence is available for casinos, in part due to the exemption of casinos from most state smokefree legislation. A few studies have examined the effects of smokefree laws on casinos. The passage of the 2007 Smokefree Illinois Act, which did not exempt casinos, provided a unique opportunity to examine the economic impact of the Act on casinos in Illinois and neighboring states. The Act was implemented in January of 2008, one month after the beginning of a national recession. Partnering with non-profit Missouri Group Against Smoking Pollution (GASP) with funding from the Kerr Foundation, a team led by Jenine Harris of CPHSS found that, after accounting for the economic downturn, there was no difference in changes in admissions across Illinois compared to admissions in three other states without a clean air act.
Missouri Tax Campaign Evaluation
In 2012, The Show-Me a Brighter Future campaign placed a ballot measure before voters to increase the Missouri tobacco tax and provide revenue for education and tobacco cessation. Missouri has a 17-cent tobacco tax, the lowest in the country. This measure would have increased the tobacco tax to $.90 and raised $283 million annually, but did not pass. Starting in 2013, CPHSS worked collaboratively with the Healthcare Foundation of Greater Kansas City (HCF)
to evaluate the tobacco tax increase efforts. The evaluation involved multiple methods in order to provide the most complete understanding of the tobacco tax campaign. Key informant interviews were combined with focus groups and media analysis to provide qualitative data. These different sources of information were combined with network and media analysis to develop a final evaluation report.
Point of Sale Study
The point of sale provides a place for tobacco companies to communicate with former, current, and potential smokers. This study looked at tobacco marketing at the point of sale in St. Louis, MO, including a comparison of advertising in stores within a 1000 foot radius of schools to advertising in stores outside of a 1000 foot radius, with hopes that data from the study could be useful in passing a comprehensive advertising ban. The study assessed whether tobacco companies choose to advertise in areas where there were a significant number of youth customers. The study also looked at whether St. Louis was being used as a test market for new cigarette brands and flavors.
In 2003, CPHSS conducted a rigorous process evaluation examining the effects of funding reductions on eight state tobacco control programs. The primary objectives of the project were: 1) to examine how state tobacco control programs were affected by challenging and unstable state financial climates; and 2) to test the effectiveness of different dissemination strategies. The project was organized into three phases: 1) a needs assessment and state selection; 2) state recruitment and data collection; and 3) data analysis and dissemination.
With support from the Robert Wood Johnson Foundation, the Rippel Foundation launched the ReThink Health Frontiers project in 2013. The project aimed to address absence of sustainable and innovative financing in health system reform. Another goal was to provide a more dynamic view of local health systems, identify funding sources, address operational barriers with clear procedures, and turn disengaged, resistant, and/or oppositional stakeholders into effective stewardship teams. In 2014, CPHSS aided in these efforts by using social network mapping to describe local stewardship networks, track the flow of financial and information resources, and identify the most important network characteristics to assure an improved health system.
School Policy Project
CPHSS partnered with the CDC’s Office on Smoking and Health to develop a tool for tobacco control practitioners and educational leaders to systematically evaluate the comprehensiveness of school tobacco control policies. Based on empirical literature and the expertise of a national advisory panel, a "gold standard" school tobacco control policy was developed, which guided the content of the Index. The Index is a practical, user-friendly tool for tobacco control professionals and educators providing them with the ability to easily evaluate their own school policies and use results to strengthen existing policies. The Index was pilot-tested using 95 Missouri school district tobacco control policies and proved to be highly reliable among raters. CPHSS is currently using the tool as part of the CPPW Evaluation.
Social Innovation for Missouri Evaluation
Since 2011, CPHSS has served as the external
evaluator of the Missouri Foundation for Health's initiative, Social Innovation for Missouri. The initiative
supports community efforts to expand physical activity options, encourage
healthier food choices, and reduce overall tobacco use.
St. Louis Secondhand Smoke Study
The secondhand smoke study assessed exposure of St. Louis bar and restaurant employees to secondhand smoke. The study examined environmental concentrations of secondhand smoke in bars and restaurants from airborne nicotine and personal exposure to secondhand smoke using hair samples taken from employees. The final study evaluation analyzed the relationship between airborne nicotine and hair nicotine concentrations and the impact of smoking restrictions, bans, and ventilation measures on secondhand smoke concentration. See final study report.
Vermont Evaluation Project
CPHSS worked with the Vermont Department of Health (VDH) and other stakeholders to develop an evaluation plan for Vermont’s Comprehensive Cancer Control Program
(Vermont CCC). CHPSS began the evaluation planning by gathering information from partners on the program background, current activities, and objectives through several meetings and key informant interviews. CPHSS then facilitated a logic model development and evaluation question brainstorming session with the Vermont CCC stakeholders. CPHSS also conducted a webinar to explain the process of prioritizing evaluation questions; the stakeholders then chose their prioritized evaluation questions using a web-based survey.The deliverables for this initial evaluation planning project were a finalized logic model and set of prioritized evaluation questions.