Chicagoland Evaluation Association Week: Assessing Evaluation Elements to Increase Sustainable Program Implementation and Health Equity by Christina Iyengar

Welcome to The Chicagoland Evaluation Association Week on AEA365! This week’s postings reflect the diversity of our Local Affiliate members and their work, using a lens of cultural responsiveness evaluation with various types of communities. We are excited to share some of our projects along with lessons learned, hot tips, and rad resources from our projects. 

–Casey Solomon-Filer, Vice President, and Asma Ali, Past- President

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Hello ! I am Dr. Christina Iyengar, from Rush University Medical Center. As the lead evaluator I support the Substance Abuse and Mental Health Services (SAMHSA) Linking Actions for Unmet Needs in Children’s Health (LAUNCH) grant. The Building Early Connections (BEC) program (currently in year 3) focuses on reducing health disparity in Chicago’s West Side. We have increased health equity through expanded access to evidence-based social-emotional and developmental screeners for young children that are administered at well-child visits. Children with emerging concerns are immediately linked to the BEC behavioral health intervention team for brief, individualized family interventions.  

We took the opportunity to expand evaluation efforts to include frameworks that help assess evaluation elements. In doing so, we have increased our ability to build a sustainable program and increase health equity. 

All program evaluation strategies align with SAMSHA’s Core strategies, Rush Community Health Implementation Plan Goals, and BEC’s domain-specific process and outcome evaluation activities. To support the evaluation strategies, we incorporated the dissemination and implementation sciences frameworks RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) and CFIR (Consolidated Framework for Implementation Research) to help frame and communicate the behavioral health focused Building Early Connections program. The unique factors of RE-AIM provided balance between internal and external validity and directed attention to design and implementation processes, while the CFIR framework provided constructive process and implementation evaluation factors. When both frameworks are applied together, they complement each other and support domain-specific evaluation activities.

Lessons Learned

RE-AIM and CFIR frameworks, when viewed through the lens of health equity, provide vital insight into a program by identifying gaps, which when addressed, support program sustainability, health equity, and increased quality of life for patients. In creating our evaluation questions, we considered each of the RE-AIM/CFIR framework factors listed below, which are grouped by stage of program implementation.

Reach

• How to improve screening and referral processes
• Awareness of how many providers refer to BEC
• The age range of patients
  

Effectiveness

• Awareness of BEC’s ability to meet the needs of communities
• The impact of the program on providers and caregivers

Implementation

• Awareness of process evaluation elements that shape the program
• Assessment of evaluation methods 

Intervention

• The feasibility of program interventions
• Adaptations that were made for program implementation

Applied RE-AIM and CFIR frameworks provided an extra layer of  evaluation questions that added to a better understanding of contributing factors for health equity.

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The American Evaluation Association is hosting Chicagoland Evaluation Association (CEA) Affiliate Week. The contributions all this week to AEA365 come from CEA members. Do you have questions, concerns, kudos, or content to extend this AEA365 contribution? Please add them in the comments section for this post on the AEA365 webpage so that we may enrich our community of practice. Would you like to submit an AEA365 Tip? Please send a note of interest to AEA365@eval.org. AEA365 is sponsored by the American Evaluation Association and provides a Tip-a-Day by and for evaluators. The views and opinions expressed on the AEA365 blog are solely those of the original authors and other contributors. These views and opinions do not necessarily represent those of the American Evaluation Association, and/or any/all contributors to this site.