What Works Here: An Ecological Approach to Community Evaluation

Altarum Institute initiated a research project, Culture of Health, to answer questions surrounding the complex interplay of genetics, economics, culture, social interactions and other factors that influence health behaviors and outcomes.

Via the Culture of Health project Altarum is identifying specific components and structural factors underpinning community-based strategies in population health. The evidence for such replicable community interventions has proven elusive. Every community is unique with its own history, supporting infrastructure, norms and values, formal and informal hierarchies and social structures that lend to the success or failure of a program. Replicating previously employed interventions is thus problematic: small differences in implementation approach and environmental context may prove critical. In this presentation we identify an ecological approach to improving community health that focuses on lasting structural change, based on enabling community leaders and citizens to identify their needs, indicators and strategies, and using formative evaluation to tailor processes and create ownership throughout the project life and beyond

Through our own inclusive efforts - including a comprehensive meta-analysis of the literature, environmental scans and structured community leader interviews - we have identified evaluation processes that translate across varying geography, public and environmental health issues, and populations, to assist communities in creating their vision of a healthier future. In this way we will dramatically expand the evidence available to public health officials and community leaders. This paradigm offers a shift in understanding from "what works" to "what works, for us, here".