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In 1999 the American Cancer Society (ACS) launched the National School Health Coordinator Leadership Institute, a groundbreaking initiative designed to enhance and invigorate school health in the nation's schools by training individual school health coordinators to act as change agents. The Institute consisted of three, week-long summer training sessions, and three, shorter midyear 'booster' sessions, with the various sessions designed to assist one cohort of participants (n = 50) to build leadership capacities to coordinate school health. This evaluation examined the effects of the Institute as measured through a panel survey of participants - school health coordinators or their equivalents - over an 18-month period. Findings suggest that substantial progress was made in institutionalizing the school health coordination function in the target school districts. Specifically, in contrast to when the training began, clear, written position descriptions are common among program participants, most have functioning school health councils in their school districts, and program trainees appear to be moving aggressively to enhance the infrastructure for school health coordination through planning, setting priorities, and assessing needs. Program trainees report spending increased time on school health coordination, and they are active in spreading the word about coordinated school health programs. Trainees viewed the Institute as relevant to their needs, though not all aspects of the program are viewed as equally useful. As possible shortcomings, the training needed more emphasis on funding for school health coordination, and a low level of evaluation skills existed among coordinators. [ABSTRACT FROM AUTHOR]

Although process evaluation usually ends with the program, process itself does not end. This study analyzed process or contextual influences health professionals face when returning from continuing professional education (CPE) and attempting to apply learning. Follow-up survey data were analyzed for a sample (N = 549) of physicians, nurses, counselors, and rehabilitation specialists. Contextual influences studied include resources, encouragement, support, opportunity, and authority. Logistic regression analysis found support for changes to apply training ideas was a predictor of application for the sample as a whole and for all professional groups except one. Encouragement from others was a predictor of application for rehabilitation specialists, and opportunity to apply learning was a second predictor for nurses. Sufficient resources was not a predictor in any models tested. Results indicate that the practice context can affect educational outcomes and an extended vision of process evaluation is needed to incorporate such variables in the evaluation of CPE. [ABSTRACT FROM AUTHOR]

BACKGROUND: Community-based outreach seeks to move libraries beyond their traditional institutional boundaries to improve both access to and effectiveness of health information. The evaluation of such outreach needs to involve the community in assessing the program's process and outcomes. PURPOSE: Evaluation of community-based library outreach programs benefits from a participatory approach. To explain this premise of the paper, three components of evaluation theory are paired with relevant participatory strategies. CONCEPTS: The first component of evaluation theory is also a standard of program evaluation: use. Evaluation is intended to be useful for stakeholders to make decisions. A useful evaluation is credible, timely, and of adequate scope. Participatory approaches to increase use of evaluation findings include engaging end users early in planning the program itself and in deciding on the outcomes of the evaluation. A second component of evaluation theory seeks to understand what is being evaluated, such as specific aspects of outreach programs. A transparent understanding of the ways outreach achieves intended goals, its activities and linkages, and the context in which it operates precedes any attempt to measure it. Participatory approaches to evaluating outreach include having end users, such as health practitioners in other community-based organizations, identify what components of the outreach program are most important to their work. A third component of evaluation theory is concerned with the process by which value is placed on outreach. What will count as outreach success or failure? Who decides? Participatory approaches to valuing include assuring end-user representation in the formulation of evaluation questions and in the interpretation of evaluation results. CONCLUSIONS: The evaluation of community-based outreach is a complex process that is not made easier by a participatory approach. Nevertheless, a participatory approach is more likely to make the evaluation findings useful, ensure that program knowledge is shared, and make outreach valuing transparent. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To develop a theoretical framework of youth empowerment in the context of a participatory community health promotion intervention, a longitudinal qualitative study was conducted. METHODS: Individual and group interviews, documents, and observations were analyzed using the constant comparative method and theoretical sampling. RESULTS: Practitioners created an environment conducive to adolescents' taking responsibility for their quality-of-life issues by welcoming and enabling youth. Power was transferred to youth as responsibility for voicing, decision making, and action. This led to positive changes in youth development and their social integration into community. CONCLUSION: Empowerment emerged as a transactional partnering process between adults and youth. [ABSTRACT FROM AUTHOR]

Part of the Community Health and Preventive Medicine Commons, Health and Medical Administration Commons, Health Policy Commons, Health Services Administration Commons, Health Services Research Commons, and the Public Health Education and Promotion Commons. Many accomplishments of public health have been distributed unevenly among populations. This article reviews the concepts of applying evidence-based practice in public health in the face of the varied cultures and circumstances of practice in these varied populations. Key components of EBPH include: making decisions based on the best available scientific evidence, using data and information systems systematically, applying program planning frameworks, engaging the community and practitioners in decision making, conducting sound evaluation, and disseminating what is learned. The usual application of these principles has overemphasized the scientific evidence as the starting point, whereas this review suggests engaging the community and practitioners as an equally important starting point to assess their needs, assets and circumstances, which can be facilitated with program planning frameworks and use of local assessment and surveillance data.

Background: Increasingly, funders expect that public health researchers will include policy contributions as outcomes. Lack of agreement as to what constitutes a policy contribution of research provides little conceptual or implementation guidance to researchers who lack policy training, as well as to evaluators called on to assess "good" policy contribution., Purpose: This study applies a previously developed policy framework to explore potential policy contributions from research conducted by 20 principal investigators of Salud America!, the Robert Wood Johnson Foundation's (RWJF) Research Network to Prevent Obesity Among Latino Children., Methods: The literature-driven "Policy Contribution Spectra" served as the conceptual framework to jointly develop 20 cases of potential policy contribution. Data collection included document reviews and interviews. Data analysis included within- and cross-case analyses, member checking, data triangulation, and expert reviews., Results: Plotting all 20 projects on the Policy Contribution Spectra showed projects have the potential to contribute to policy across intervention types (e.g., needs assessment or applied research); levels (e.g., local or state); timing (e.g., before or after policy enactment); and outcomes (e.g., process action or health benefits). Potential policy contributions on the Spectra framework were shown as multidirectional; multilayered (e.g., simultaneous state and local action); and multidimensional (e.g., multiple strategies aimed at multiple stakeholders)., Conclusions: The Policy Contribution Spectra adds a useful policy lens to existing public health practice by enabling researchers, funders, advocates, and evaluators to visualize, reframe, discuss, and communicate with policymakers and the public to resolve important public health issues., (Copyright © 2013 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.)

Background: The Robert Wood Johnson Foundation requested this utilization-focused evaluation of its Active Living Research (ALR) program. This evaluation reports on the trajectory of influence of past and future ALR outcomes on field-building and policy contributions as well as on possible users of completed and disseminated ALR products., Methods: In 2006 and 2007, key-informant interviews were conducted with 136 representatives of first-line potential users of ALR research products, including state physical activity and nutrition program coordinators, policymakers, scientists, and funders. Literature reviews, bibliometric analyses, and document reviews served to describe the context for ALR's work and the ways it could enhance its utility for field building and policymaking., Results: The contributions of ALR to the emerging transdisciplinary field included leadership in the development of measurement tools, epidemiologic studies, implementation research, the translation of research to practice, and the communication of learned lessons to diverse audiences. ALR's contributions to policy discussions were found across a spectrum of policy-development phases that included describing the problem, raising awareness of alternative strategies for increasing physical activity, convening nontraditional partners, and evaluating policy implementation., Conclusions: Policy-relevant research can make contributions to policymakers' thinking but almost never causes a change by itself. Five years after the original authorization of ALR, there is ample evidence of its recognition as a resource by key players, its field-building influence, and its contributions to policy discussions. All these bear promise for a broader contribution to obesity prevention. Recommendations for increasing ALR's impact on policy and practice are offered.

Legislators and their scientific beneficiaries express growing concerns that the fruits of their investment in health research are not reaching the public, policy makers, and practitioners with evidence-based practices. Practitioners and the public lament the lack of relevance and fit of evidence that reaches them and barriers to their implementation of it. Much has been written about this gap in medicine, much less in public health. We review the concepts that have guided or misguided public health in their attempts to bridge science and practice through dissemination and implementation. Beginning with diffusion theory, which inspired much of public health's work on dissemination, we compare diffusion, dissemination, and implementation with related notions that have served other fields in bridging science and practice. Finally, we suggest ways to blend diffusion with other theory and evidence in guiding a more decentralized approach to dissemination and implementation in public health, including changes in the ways we produce the science itself.

Efforts at reducing tobacco use in the United States and Canada over the last half century have been amazingly successful. This article examines those efforts in order to identify policies, programs, and practices found useful in tobacco control that might be usefully disseminated to world populations to improve rates of physical activity. Tobacco-control activities began with efforts to influence the individual smoker through public education and counter-advertising. Increasing awareness of the addictive properties of tobacco, industry efforts to manipulate those properties, and to target youth with aggressive advertising, fueled public outrage that supported additional policy changes to include community interventions, legal actions, and restraints against the tobacco industry. The article first examines ways to view the process of transferring knowledge from one enterprise (reducing tobacco consumption) to another (increasing physical activity). Several theories of knowledge generalization and dissemination are explored: transfer, knowledge utilization, application, diffusion, and implementation. The second section identifies the dissemination of tobacco control by means of brief health behavior-change interventions for smoking cessation that have been successfully integrated into primary clinical care. The question of whether similar strategies can be successfully disseminated to increase physical activity is examined in detail. The article then moves on to look at the success of arguably the most successful program in the world at achieving a reduction in tobacco control-the State of California. Finally, we compare and contrast some of the lessons as they have played out in another national context-Canada. In the concluding section, some lessons are identified that we believe may be successfully utilized in societal attempts to increase physical activity in world populations.