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APHA Scientific Session and Event Listing

Ryan Ehrensberger, MPH¹, Adrienne E. Keller, PhD², and Ashley Cunningham, BS¹. (1) CARMA, Bon Secours Richmond Health System, 2025 East Main St., Suite 207, Richmond, VA 23223, 804-644-2149, rehrensberger@carmakids.org, (2) Prevention Research, University of Virginia, P.O. Box 800623, Charlottesville, VA 22908

The Central Virginia Asthma Coalition (CVAC) was created by community members to address the high asthma morbidity in the Richmond area. In 2001, CVAC received a multi-year CDC grant as part of the Controlling Asthma in American Cities Project. Controlling Asthma in the Richmond Metropolitan Area (CARMA) is managed by one of CVAC's participating organizations, Bon Secours Richmond Health System. Interventions are organized and evaluated through the small CARMA central team, but are designed and carried out through the collaborating organizations. CARMA, like many such studies, requires formal evaluation to assess effectiveness at individual, risk group and population levels. The inferential line from intervention to effectiveness requires process, outcome and impact evaluation, with most of the data collected by the participating organizations. Over the four years of funding, we have identified and developed strategies to meet the primary evaluation challenges within such multi-organization, multi-intervention, multi-outcome, community collaborative projects. We organize these challenges into four levels. For process evaluation, the primary challenges are the extra burden that data collection imposes on front-line staff and protecting the identity of clients. For outcome evaluation, the primary challenges are related to appropriate follow-up to identify sustained effects. For impact evaluation, the primary challenges include access to appropriate community-level and comparison data, and appropriate strategies for identifying non-controlled mediating and modifying variables. Finally, the organization and tracking of the evaluation protocol is in itself a significant challenge, including ensuring continuity through staffing and volunteer changes as well as changes in organizational mandates, priorities and funding.

Learning Objectives: