Evaluating policy advocacy: Lessons from an environmental policy initiative in California

Purpose: This paper presents data on the dynamics of local coalitions in their work on environmental policies to reduce risk factors for asthma in school-aged children. Several components of the work are discussed: (1) concepts and data related to the dynamics of successful coalitions, and those that faced significant barriers; (2) interactions between local and statewide coalition work; and (3) place-based approaches to the social disparities of health. Seven years of data on outcomes of policy advocacy are presented using systems change concepts to evaluate building a synergistic movement. Discussion points: Outcome measures are presented for policy advocacy, collaboration, and media usage. The primary policy intervention areas include: housing, schools, and outdoor air. The coalitions' successes and barriers to create synergy across local and statewide arenas are discussed. Additionally, the approaches coalitions employed to educate their communities and to create policy and systems change employing the social disparities of health are analyzed. Examples of communities' strategies to leverage their resources to create sustainable policies are included to provide maximum accessibility to relevant lessons. Conclusion: Multiple policy outcomes, ranging from organizational procedures to redesigning policies for slum housing and goods movements across the State, have been undertaken by community coalitions in California, many with substantial success. Mature and middle coalitions gained traction more quickly than younger coalitions; however, strategies to share lessons and practices enabled younger coalitions to enhance their success rates and more mature coalitions to diversify approaches. Suggestions for creating synergy and maximizing effectiveness of policy advocacy are included.