Evaluation of faith-based public health interventions

Purpose: Interventions targeting multiple levels require complex evaluation strategies. The purpose of the 18-month Healthy Congregations in Action (HCIA) initiative was to develop capacity of health ministry teams to develop and implement outcomes-based plans targeting health behaviors at the individual, inter-personal and congregational levels. Evaluation measured change in congregational environment and policy, leadership team development and individual behavior and intent. RE-AIM was implemented to measure process.

Methods: Data collection tools were identified and modified for this specific application. Self-report Health Risk Assessments (HRA), leadership team development assessments (LTDA) and congregational self-assessments (CSA) were used along with RE-AIM for process and outcome reporting. Data was collected at baseline, 1 and 2 years (follow-up) by trained congregational leadership teams using protocols.

Results: The HRA: 42% reported they were as healthy as they could be at year 1 compared to 58% at baseline. The LDTA: a significant change in team members who did not like the responsibilities they had on the team (59% at baseline vs. 11% at 1 year follow-up). The CSA: 69%% included health ministry in their budgets at year 1 compared to 29%% at baseline. RE-AIM: 61% had followed their initial plan of action and met the objectives set forth in their plans with 74% successfully reaching intended audiences. Challenges were experienced with each of these instruments. Follow-up data is currently being collected and will be reported.

Conclusions: A multi-level evaluation provides a complete picture of the process and outcomes of a community intervention and provides feedback for further work.