Assessment of Nutrition and Physical Activity Policy in St. Louis Childcare Settings
We 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.
Best Practices Evaluation
In 1999, the Centers for Disease Control and Prevention published the Best Practices for Comprehensive Tobacco Control Programs, the first evidence-based set of recommendations for how states should develop and fund comprehensive tobacco control programs. In 2001, we 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 inform the development of a 2007 update to Best Practices.
Communities Putting Prevention to Work (CPWW) Project Evaluation
The U.S. Department of Health and Human Services’ CPPW Initiative supported community public health efforts to improve nutrition, increase physical activity, reduce obesity, and decrease tobacco use. In collaboration with the Saint Louis University School of Public Health, we served as the main evaluator of the project from 2010-2012. Evaluation examined both process and outcome measures through changes in four domains: policy, systems, environmental, and behavioral and social. The St. Louis County Tobacco Control Network was also evaluated using data collected from a social network analysis survey and key informant interviews.
Healthy & Active Communities Initiative Evaluation
We 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, built environment, advocacy, and policy change.
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.
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.
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.
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.
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.
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.
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.
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, we 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 basic needs and financial stability, child welfare, disabilities, early childhood education, health, mental health and substance abuse, and youth development. The results were used in United Way’s strategic planning process and shared with community stakeholders.
Community Capacity Assessment Project
In 2007, we were 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.
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 to develop networks with a national scope to address tobacco-related disparities in priority populations. We conducted an evaluation in 2008 to evaluate progress made by the networks on 1) Maintaining and strengthening a national tobacco control network; 2) Facilitating learning and information sharing between various stakeholders; 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.
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.
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.
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 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.
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.
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.
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.
Tobacco Control Guides
In 2014, we collaborated with Public Health Law Center in St. Paul, Minnesota, a program of 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 are designed to provide tobacco control partners with practical guidance on selecting and implementing evidence-based tobacco control strategies.
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.