Evaluation of a multi site asthma program initiative: Linking program activities with distal outcomes to demonstrate systems change

Five unique community interventions to reduce childhood asthma morbidity and to facilitate healthcare and community systems level changes were developed and privately funded in GA. In an effort to document these outcomes and facilitate a multi site level of understanding, the funder also contracted with our university-based evaluation team. Our team worked with program staff and developed a plan to document both program level evaluation and cross site measures (process, impact and outcome). The funded projects were charged with increasing enrollment of children and the management of their asthma. They used best practice interventions and planned to document that systems changes did indeed improve care as measured by emergency room visit reductions, hospitalization reductions, reduced school absences, increase quality of life and/or reduction of acute care primary care visits. The evaluation team worked to support the program leaders in their efforts to link the program activities and objectives with the more distal outcomes they hoped to achieve, such as reduced ER use, reduced hospitalization or reduced school absenteeism. This presentation will document the processes the evaluation team used to support the linking of the systems objectives to the distal outcomes through more short term or intermediate outcomes such as changes in timely use of appropriate medications or reduction in triggers for asthma. The need to produce a clear link between the program activities, systems changes and outcomes through evaluation evidence is critical when calling for policy change.