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Collective impact (CI) is a structured approach that helps drive multi-sector collaborations to address social problems through systems changes. While the CI approach is gaining popularity, practitioners experience challenges in evaluating its implementation and intended outcomes. We conducted a systematic scoping review to understand evaluation methods specific to CI initiatives, identify challenges or limitations with these evaluations, and provide recommendations for the design of CI evaluations. Eighteen studies met the inclusion criteria. Process evaluations were the most frequently used evaluation design. Most studies collected cross-sectional data to evaluate their efforts. The complexity of CI was most frequently cited as the greatest evaluation challenge. Study recommendations primarily focused on improvements during the evaluation planning phase. Taking careful consideration in the planning of CI evaluations, developing context-specific data collection methods, and communicating results intentionally and effectively could prove useful to sufficiently capture and assess this systems-level approach to address social problems.

In 2007 the Oregon Legislature passed a policy requiring students receive a minimum weekly amount of physical activity in school: 150 minutes for elementary and 225 minutes for middle school students. However, no implementation guidance for teachers or school districts were included in the policy. This pilot study examines the differences between teachers using a single paid curriculum versus various free or readily available resources to implement physical activity. Fifteen elementary-level classroom teachers (8 intervention, 7 control) engaged in the study. Intervention teachers received access to Focused Fitness Curriculum; control teachers used already available resources, representing treatment as usual. Researchers administered teacher surveys, classroom activity logs, classroom observations, and teacher interviews to look at activities conducted, time in physical activity, and teacher perceptions. The average duration of physical activity was almost double in the control group compared to the intervention group. Additionally, the control group maintained small increases in activity level throughout the semester, while activity levels of the intervention group fell. However, the treatment group had higher average activity levels and student participation. The treatment group, using the paid curriculum, was not better than the control group. Both groups saw positive outcomes of students engaging in physical activity. Rather than one set curriculum, the more important factors are providing support and flexibility for implementation.

The Sexual Health And Peer Education (SHAPE) program implemented in middle schools in Oklahoma County utilizes a hybrid adult and peer educator model to deliver sexual health programming. While peer educators have been incorporated into school-based sexual health programs in the past, this program is unique in its approach to preparing and engaging peer educators. Researchers synthesized data from interviews with program implementers and focus group discussions with teenage peer educators and middle school students who recently participated in the program to understand the process elements that contribute to the benefit of the SHAPE program model. Interviews with program implementers described the thorough peer educator recruitment and training process. Teenage peer educators felt well-prepared to deliver lessons, and through this program, they developed leadership skills, confidence, and grew personally. Middle school students revealed that peer educators were relatable and provided a positive experience where they could engage and ask questions. The application of a hybrid adult and teenage peer educator model proved useful for delivering sexual health topics and benefited students and teenage peer educators. This study's findings highlight elements that can be utilized in future sexual health programming to prepare and engage teenage peer educators in more meaningful ways.

Game-based learning offers an interactive and effective way to teach health content and skills. This article discusses feasibility testing of "Using the Connect" ("UTC"), an innovative, game-based sexuality education program to evaluate its acceptability among youth. Utilizing mixed methods in a single case study design, qualitative and quantitative data was collected from youth (surveys, facilitated discussions, and observations). Qualitative data triangulated quantitative findings that youth liked the program design, felt the games and content were relatable, and learned knowledge and skills around adolescent development, accessing information, communication, and making healthy decisions through playing the games. Overall, "UTC" was highly acceptable to the youth; they had fun and learned information and skills. Not only would most participants recommend the program to friends, all reported they would participate in the program again and use the information they learned in the future.

Although US teenage birth rates substantially decreased over the past two decades, it still remains the highest in the developed world. More innovative, community-wide initiatives are needed to combat the issue. In Oklahoma County, Oklahoma, the Central Oklahoma Teen Pregnancy Prevention Collaboration is utilizing the collective impact model to convene multiple organizations with the goal of making systems-level changes related to teenage pregnancy within the community. This study used an interorganizational network analysis to evaluate the current strength of relationships between organizations in the Collaboration. An interorganizational network survey assessed collaborative relationships (e.g. information sharing and joint planning) within the network. Using R software, network diagrams were developed to depict partner relationships, and network measures, including node-, group- and network-level measures, were calculated. The network depiction (n = 23) revealed that the network core was composed of organizations from multiple sectors, and the backbone organization served as the most central organization for most centrality measures. This study provides insight into how organizational relationships can be assessed in order to increase community capacity to address teenage pregnancy. Continuous monitoring of the strength of relationships is important to ensure success in achieving goals as well as collective impact.

Introduction: In 2014, the Centers for Disease Control and Prevention funded the American Heart Association to implement policy, systems, and environment-focused strategies targeting access to healthy food and beverages, physical activity, and smoke-free environments. Method: To understand factors affecting implementation and variations in success across sites, evaluators conducted a multiple case study. Based on past literature, community sites were categorized as capacity-building or implementation-ready, for comparison. A sample of six communities were selected using a systematic selection tool. Through site visits, evaluators conducted interviews with program staff and community partners and assessed action plans. Results: Evaluators identified important implications for nationally coordinated community-based prevention programming. Differences in implementation varied by the communities' readiness, with the most notable differences in how they planned activities and defined success. Existing partner relationships (or lack thereof) played a significant role, regardless of the American Heart Association's existing presence within the communities, in the progression of initiatives and the differences observed among phases. Last, goals in capacity-building sites were tied to organizational goals while goals in implementation-ready sites were more incremental with increased community influence and buy-in. Discussion: Using national organizations as a mechanism to carry out large-scale community-based prevention work is a viable option that provides coordinated, wide-scale implementation without sacrificing a community's priorities or input. In funding future initiatives, the presence of relationships and the time needed to cultivate such relationships should be accounted for in the planning and implementation processes, as well as both local and national expectations.

BACKGROUND: Youth may be reluctant to seek health care from school health providers due to feeling embarrassed or stigmatized in the health office environment or worried about their confidentiality. The purpose of this project was to create a set of youth‐centered health posters that promote youth engagement with nursing staff and to standardize health messaging across high schools in Hawaii school‐based clinics. METHODS: Two community advisory boards, 1 composed of 10 youth stakeholders (mean age 17 years) and the other of 7 adult stakeholders, informed poster development utilizing web‐based discussion groups. The discussions were transcribed, and additional data was collected using field notes and anonymous digital messages. Adult advisory board members also provided feedback on suggested poster text through an online survey. RESULTS: Youth and adult advisory board participants identified 4 key health concerns facing youth: confidentiality, sexual health, relationships, and mental health. Based on input from the 2 advisory boards, 4 posters were developed, each centered on 1 key health issue. IMPLICATIONS FOR SCHOOL HEALTH POLICY, PRACTICE, AND EQUITY: School‐based posters can convey important messages to help youth understand their health care rights and responsibilities, as well as identify important issues open for discussion with nurses. CONCLUSION: Posters are an underutilized tool for school health providers to create welcoming, inclusive health care environments and facilitate health‐related conversations with youth. This paper describes participant feedback about the characteristics of a memorable poster and briefly outlines current knowledge and recommendations for school health providers regarding each of the 4 health issues. [ABSTRACT FROM AUTHOR]

Black mothers experience markedly disproportionate maternal morbidity and mortality in the United States, with racism often cited as the root cause manifesting through several pathways. The study examined Black mothers' perceived provider communication, support needs, and overall experiences in the neonatal intensive care unit (NICU). This study used grounded theory embedded in the Black feminist theoretical (BFT) framework to generate new ideas grounded in the data. Data was collected through semi-structured interviews using videoconferencing, with questions related to the mother's overall NICU experiences, communication within the NICU, and perceived support needs. Data were analyzed using thematic analysis. Twelve mothers participated in the study; most were married (n = 10), had a cesarean birth, had a previous pregnancy complication (e.g., diabetes, hypertension), had attained a graduate degree or more (n = 9), earned an annual household income of $75,000 or more, and were between 35–44 years of age (n = 7). Three broad domains with several accompanying themes and sub-themes were identified, explicating the mother's experiences in the NICU. Specifically, factors influencing NICU hospitalization for mothers included maternal care/nursing experiences, interactions in the NICU, and the perceived support need that might attenuate negative care and birthing experiences.. The study adds to the growing literature championing Black maternal health equity and multilevel quality improvement strategies to foster equitable maternal health. Our study reinforces the need for racially congruent interventions and policy reformations to protect Black birthing people regardless of socioeconomic factors and social class using life course, holistic approaches, and intersectionality mindset. Importantly, using the BFT, this study calls for culturally sensitive research to capture the nuances associated with the multiplicity of experiences of Black people. [ABSTRACT FROM AUTHOR]

Collaborative capacity within coalitions is required to promote healthy communities and create systemic change. The purpose of this study was to evaluate the quality of three Tobacco Prevention and Control Coalitions' action plans for their likely ability to address health equity through tobacco cessation efforts. To do this, the Butterfoss State Plan Index was adapted for relevance to community-oriented coalitions, with a focus on health disparities and tobacco control. This study compares three tobacco control coalitions in Texas to quantify their efforts on addressing health disparities through a standardized measurement process. The results of this assessment indicate that there are gaps in existing coalition assessment tools, and action plan norms and requirements, specifically as it pertains to addressing health disparities in a systematic way. Through a systematic analysis of coalition action plans and supporting documents, it is clear that there is a need for more standard inclusion of disparities-focused work within action plans. Community health researchers, coalition members, and coalition funders should consider action plans to be living, iterative documents that are subject to adjustments. Systems-thinking perspective should be used to develop action plans adapted to environmental, community, policy, and other changes. Lessons learned from this study can provide an example of how to incorporate strategies for reducing health disparities within coalition action planning. [ABSTRACT FROM AUTHOR]