Partnering with Community Health Councils to Assess Systems Change

In New Mexico, 37 health councils, covering 32 counties and five tribal health coalitions, have been legislatively mandated and funded by the Department of Health to engage in local Community Health Improvement (CHI) processes and partnerships. The CHI process is a deliberate approach in which communities and the NM DOH share responsibility and accountability for increasing community capacity to improve community health. The approach emphasizes council development, planning and priority setting, and council/community actions to promote community health and enhance health improvement efforts. Since August 2007, the Office of Health Promotion/Community Health Improvement (NM DOH) and the health councils have partnered with the University of New Mexico (UNM) to develop and implement a statewide evaluation of the councils' impact on community health systems.

We report on the first two stages in the planned multi-year evaluation, including the identification of common, overarching elements in the councils; the development and refinement of the program logic model; and a pilot evaluation of selected systems and capacity outcomes and indicators developed through a participatory evaluation process.

We emphasize the participatory processes used to engage health council members and council coordinators in refining intermediate systems and capacity outcomes and identifying indicators for these outcomes. We also discuss the challenges of a participatory evaluation approach in a large, rural state and the benefits of such an approach to document and assess the contribution of community health councils in a health improvement process.