Evaluating Community-Based Policy Making Outcomes: A case study analysis

With the increased realization that basic behavioral change is the key to reducing the increasing rates of chronic disease, the importance of policies, and systems that positively impact a community's built environment, a worksite's wellness program and a schools practices are coming to the forefront. However there is a need for greater understanding of the factors that facilitate or obstruct community-based policy development.

This paper evaluates the impact of a five-year program that advocated for community-level policy and system changes. The paper is an evaluation of the Steps to a HealthierPA project, a chronic disease prevention program with the goal of affecting community-level policy and system change across three 3 counties.

The paper presents the results of a five-year evaluation of the project's work with 150 community organizations to enact system and policy changes in 50 municipalities, 21 school districts and 34 worksites. Analyzing 30 case studies using cross-case and within-case analysis the paper identifies the key factors in each case that facilitated or hindered the development and the enactment of policy and/or system change.

The preliminary results show that the presence of; i) existing coalitions; ii) large institutions or organizations; and iii) large rural areas, were barriers to policy change. While i) the presence of state level officials; ii) the use of evidence based programs; and iii) the media visibility of the intervention facilitated system and policy change.