REACH Grantees Evaluation Work

Four REACH grantees, The American Heart Association/American Stroke Association, Partners In Health, Presbyterian Healthcare Services and the REACH Pima Partnership recently shared the evaluation work they have been doing for their respective grants.

The American Heart Association/American Stroke Association (AHA/ASA) is working collaboratively with health coalitions in the county of El Paso, Texas, to strengthen health systems and accelerate improvements across tobacco, nutrition, and physical activity. As one component of their overall evaluation strategy, they recently completed a series of focus groups with mothers and interviews with health professionals serving women in El Paso County. They are gathering feedback from mothers and health professionals to understand how they can help create supportive environments and systems that encourage low-SES Hispanic and Black/African American mothers in El Paso County, Texas to breastfeed their babies. They are in the process of transcribing and coding the results of the focus groups and interviews. For the breastfeeding evaluation work, summary results have been completed and will be shared with their partners to inform future program activities related to breastfeeding strategies in El Paso County.

Partners in Health is working with Navajo communities to increase the consumption of healthier foods by: enhancing healthier food procurement and sales; strengthening regional food systems by expanding the Navajo Fruit and Vegetable Prescription (FVRx) Program; and supporting new Farm to School initiatives. In addition, they are supporting community planning and execution of trail projects. Partners in Health is evaluating the impact of their FVRx program on individual’s health outcomes (health behaviors and BMI) and food insecurity. The evaluation will also include the impact of their widespread Healthy Navajo Stores Initiative on supply and promotion of healthy and traditional foods, and beverages, as well as consumer purchasing behavior. A manuscript about the FVRx implementation has been accepted for publication and will be shared when published.

Presbyterian Healthcare Services (PHS) and dozens of their REACH community partners are connecting patients to free community-based programs that focus on healthy eating (e.g., the Healthy Here Mobile Farmers’ Market, Presbyterian Food Farmacy), physical activity (e.g., Zumba classes, walking groups) and chronic disease self-management (e.g., Diabetes Self-management Prevention Program). The connection is made through use of the Wellness Referral Center (WRC) operated by Healthy Here partner Adelante Development Center (Adelante). Healthcare providers at community-based clinics refer patients diagnosed with, or at risk for, diabetes, hypertension, high cholesterol and obesity to community-based programs. The WRC then works with these individuals to connect them to the appropriate programs.

The University of New Mexico Prevention Research Center (UNM PRC) is evaluating the wellness referral system in partnership with PHS, Adelante, health clinic staff, and community programs. The evaluation measures the number of participating clinics, the number of participating providers, the number of referrals, and the number of people that enroll in and complete community programs. Adelante captures referral data using Salesforce software and shares the data with the UNM PRC for analysis.

In 2020, the UNM PRC will also begin analyzing patient health data to examine changes in blood pressure, BMI, and hemoglobin A1c following participation in community programs. PHS clinics capture these data in the electronic medical record, and a data analyst with PHS will match the data to referral data and then de-identify the data for analysis. These data will be used to demonstrate the health effects of this community-clinical linkages effort.

For their Physical Activity strategy, the REACH Pima Partnership (RPP) is focusing on a multi-use paved path that runs throughout the city of Tucson in Pima County. This path is known as the Chuck Huckelberry Loop, or simply the Loop, and runs in a literal loop throughout the city for over 120 miles. In order to track use of the Loop, their evaluation and programmatic teams are working to install infra-red counters in strategic areas of the Loop. These areas were chosen based on priority zip codes- areas with the highest concentration of American Indian and Latinx populations. In addition to keeping track of how many Loop users are drawn to these areas, RPP developed a survey on Pima County’s citizens use of the Loop. This survey addresses what draws people to the Loop, what barriers keep them from using it, and how it can be made more accessible to the community. The program team created a series of monthly events on the Loop in different priority areas that are key to the distribution of these surveys, in addition to raising awareness of the Loop itself.

The RPP is additionally collaborating with the Department of Transportation and Parks and Recreation to conduct focus groups and pocket park workshops in targeted priority zip codes. These focus groups and workshops with community members are helping RPP identify areas for the creation of enhanced destinations and ways in which routes to these destinations may be improved under current city improvement plans, specifically the Complete Streets Project. GIS maps will be used to measure the linear miles of route and destination enhancements along the Loop. Since physical activity is the RPP’s long-term strategy, gathering and evaluation of this data will be ongoing throughout the duration of the grant.

For their Community Clinical Linkages strategy, the RPP implemented a referral form that will be used in partnering clinics, faith-based organizations, and hospitals to track how many of their priority population’s patients are being referred into the public services available to Pima County residents. These resources include WIC, SNAP, Arizona’s Smoker’s Helpline (ASHLine), Chronic Disease Self-Management Program (CDSMP), and diabetes education programs. Community health workers (CHWs) will be placed within clinics, faith-based organizations, and hospitals to provide education on these programs and will use the referral forms themselves. Ideally, the CHWs placed in the health organizations will have completed the RPP’s Mothers in Arizona Moving Ahead (MAMA) program and the CHW certification program offered post-MAMA. These CHWs will also follow-up on the referrals to track actual enrollment of those referred into these programs. This data collection and analysis will also be ongoing throughout the duration of the grant.

For their Tobacco Strategy, RPP is tracking the number of apartment complexes that agree to adopt a smoke-free policy. The program team is currently collaborating with work site partners to aid in creating or strengthening workplace wellness programs, with a focus on tobacco and smoke-free incentives. Once training is in place, the evaluation team will develop the evaluation materials. The RPP’s program team is additionally working with their youth coalition, Toltecalli Strong, to change their school’s policy to include anti-vaping language, with the goal of eventually implementing these same changes at other schools and public spaces. Evaluation for these efforts will be ongoing throughout the duration of the grant.