Expanding Coverage Initiative
CPHSS served as the external evaluator for Missouri Foundation for Health’s (MFH) Expanding Coverage Initiative. We used a mixed-methods approach based on process, implementation, and outcome evaluation best practices to evaluate activities conducted by the Initiative grantees, components of the Health Insurance Literacy program, and components of the Cover Missouri Coalition.
CPHSS was a key partner on this grant, awarded to WashU’s Health Equity Works foundry. We worked with two high-need St. Louis area school districts (Normandy and St. Louis Public Schools) to determine the key relationships, messages, and systems necessary to make schools healthy environments for learning and development. The team developed a toolkit detailing the human and systems components required to implement the Whole School, Whole Community, Whole Child model to advance school health.
Heart Disease and Stroke Prevention Policy Analysis
In collaboration with the CDC’s Division for Heart Disease and Stroke Prevention, we helped develop a system to assess policies related to heart disease and stroke prevention and the extent that states have enacted evidence-based laws that address disease prevention. To assess the extent that state laws are evidence-based, the Quality and Impact of Component Evidence Assessment was developed. In 2014, the HDSP team used QuIC to identify and assess evidence for 14 components of community health worker policy. The results are summarized in the Policy Evidence Assessment Report: Community Health Worker Policy Components.
ICTS Precision Medicine
CPHSS led a needs assessment in partnership with the leadership of the Precision Medicine Function of the Institute for Clinical and Translational Sciences at Washington University in St. Louis. We utilized key informant interviews, focus groups, and a survey to better understand the facilitators and barriers to doing precision medicine and how the function can advance future efforts.
Implementation of Evidence-based Guidelines by State Tobacco Control Programs
In collaboration with the National Association of Chronic Disease Directors and the CDC’s Office on Smoking and Health, we conducted a multi-state evaluation 2007 Best Practices for Comprehensive Tobacco Control Programs. The research team traveled to seven states and Washington, D.C. to conduct interviews with tobacco control partners. The goal of the project was to examine how tobacco control partners were using Best Practices and other evidence-based guidelines. The evaluation findings were disseminated to states, the CDC, and other stakeholders through state profiles, and national conferences and meetings.
CPHSS conducted network analysis for the Howard Hughes Medical Institute (HHMI) to better understand the personal social networks of students with STEM majors with regard to the people they talk to about their academic success. The goal of the project was to increase retention of under-represented minorities in STEM majors by examining students’ relationships with STEM faculty, advisors, and peer leaders.
Mapping National Tobacco Control Leadership and Activities
Various DHHS agencies carry out tobacco control funding and planning activities. To develop and carry out these activities, staff must be able to communicate with one another, coordinate activities, build partnerships, and work towards reducing the health burden of tobacco. The primary aim of this project was to create a map of the tobacco control leadership within DHHS. Partnering with the DHHS, NIH, CDC, and Battelle, we led the data collection and analysis efforts for this project.
Midwest Casino Study
The 2007 Smokefree Illinois Act, which did not exempt casinos, provided opportunity to examine the economic impact of the Act on casinos in Illinois and neighboring states. The Act was implemented one month after the beginning of a national recession. Partnering with non-profit Missouri Group Against Smoking Pollution, we found, after accounting for the recession, there was no difference in admissions across Illinois compared to admissions in three other states without a smokefree act.
Missouri Tax Campaign Evaluation
In 2012, The Show-Me a Brighter Future campaign placed a measure before voters to increase the Missouri tobacco tax. Missouri has the lowest tobacco tax 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, we worked with the Health Forward Foundation (formerly Healthcare Foundation of Greater Kansas City) to evaluate the tax increase efforts. This evaluation included interviews, focus groups, and media analysis. This qualitative data was combined with network analysis to develop a final evaluation report.
This study looked at tobacco marketing at the point of sale in St. Louis, MO, and compared advertising in stores near schools to advertising in stores farther in distance, with hopes that this data could be useful in passing an advertising ban. The study assessed whether tobacco companies choose to advertise in areas where there were a significant number of youth customers, and whether St. Louis was being used as a test market for new cigarette brands and flavors.
Missouri’s Project LAUNCH (Linking Actions for Unmet Needs in Children’s Health) was a SAMSHA-funded program working to ensure high quality early childhood programs in Missouri. CPHSS contributed to the overall evaluation by using network analysis to understand linkages between organizations providing services to children and assessing coordination of service provision among these organizations over time. In addition to network mapping, we conducted parent interviews to capture information about families’ experiences with services. Results of this evaluation informed process improvement and helped to determine the overall service transformation within this system.
In 2003, we conducted a process evaluation examining the effects of funding reductions on eight state tobacco control programs. Primary objectives 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.
Raising St. Louis Evaluation
Raising St. Louis is an initiative originally launched by BJC Healthcare and currently administered by St. Louis Children’s Hospital that aims to utilize two well-established early childhood programs—Nurses for Newborns and Parents as Teachers—to improve the health, developmental, and school outcomes of St. Louis children pre-natal-8 years old. The initiative offers services to expectant and new parents through home visits, provide childcare items, perform child health exams, and invite parents to meet and share experiences with other parents.
Regional Arts Commission Evaluation Planning
CPHSS led a series of facilitated evaluation planning sessions for the Regional Arts Commission in St. Louis’ Community Arts Training (CAT) Institute. We used a participatory approach for engaging stakeholders in the evaluation planning process and produced a logic model and a set of prioritized evaluation questions. We then identified data collection and analysis approaches for answering those questions.
The St. Louis City Re-Entry Community Linkages (RE-LINK) project, led by the St. Louis Integrated Health Network, aimed to enhance access to social services for community re-entrants released from St. Louis City jails.
CPHSS collaborated with the Brown School’s Evaluation Center to measure progress on improvement of coordination and linkages among organizations providing services to re-entrants. We used social network analysis to examine the changes in levels of communication, collaboration, and referrals among provider organizations, as well as the kinds of service activities on which they collaborated. Results of this evaluation provided baseline, midpoint, and final evaluation measurements to highlight gaps, opportunities, challenges, and progress of the network over the course of the project.
With support from the Robert Wood Johnson Foundation, the Rippel Foundation launched the ReThink Health Frontiers project in 2013. The project aimed 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, we 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
We partnered with the CDC’s Office on Smoking and Health to develop a tool for tobacco control practitioners and educational leaders to evaluate the comprehensiveness of school tobacco control policies. This project created the Index, which 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.
Smoke Free St. Louis Coalition
CPHSS worked with Smoke Free St. Louis Coalition to develop a data collection protocol and analyze and synthesize data for measuring Indoor Air Quality in hospitality venues.
Social Innovation for Missouri Evaluation
From 2011 to 2014, we served as external evaluator for Missouri Foundation for Health’s initiative, Social Innovation for Missouri. The initiative supported 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. The final 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.
CPHSS performed a preliminary bibliometric/citation analysis of the development of Dissemination & Implementation research for the Strategies In Disseminating Evidence for Chronic Disease Prevention (STRIDE) project.
Tobacco Control Guides
In 2014, we collaborated with the Public Health Law Center in St. Paul, Minnesota, to publish a series of evidence-based tobacco control guides. Topics for these guides were identified as high-priority areas by an advisory workgroup of local, state, and national experts. The guides were designed to provide tobacco control partners with practical guidance on selecting and implementing evidence-based tobacco control strategies.
Tobacco Prevention and Cessation Initiative (TPCI)
We served as the external evaluator for the Missouri Foundation for Health’s Tobacco Prevention and Cessation Initiative. As external evaluator for TPCI, we assessed the effect of foundation-supported tobacco prevention and control programs on tobacco use in Missouri. We also provided evaluation technical assistance and training for all grantees.
Vermont Evaluation Project
We worked with the Vermont Department of Health and other stakeholders to develop an evaluation plan for Vermont’s Comprehensive Cancer Control Program. We began evaluation planning by gathering background information from partners, current activities, and objectives through several meetings and interviews. We then facilitated a logic model development and evaluation question brainstorming session with stakeholders. We also conducted a webinar to explain the process of prioritizing evaluation questions; stakeholders then chose their prioritized evaluation questions using a survey. Deliverables for this project were a finalized logic model and set of prioritized evaluation questions.