Closing the Gap: Lessons learned in an evaluation of community-based projects to reduce health disparities among minority and underrepresented groups

Background: Mandated by ‘Reducing Racial and Ethnic Health Disparities: Closing the Gap Act', the FDOH, Office of Minority Health has been funding programs to reduce health outcome disparities and promote disease prevention activities among underserved communities in Florida, in designated disparity areas such as diabetes, cancer, cardiovascular diseases, maternal and infant mortality, HIV/AIDS, adult and child immunization, and oral health care. Objectives: To conduct an evaluability assessment and evaluation of Closing the Gap to establish the indicators for immediate impact and outcomes based on data collected by the projects and to formulate evidence- based recommendations for the future. Methods: Both qualitative and quantitative methods were used to assess evaluability, and to evaluate process, impact, and outcomes. Quantitative analyses were done in each area of health to quantify the pre and post intervention changes in recommended indicators during 2006-2007, 2007-2008 and 2008-2009 project periods. Data on 53 projects in seven different health areas are combined and analyzed for significant proportional changes. A survey was also conducted among project participants to measure satisfaction in service, staff, cultural sensitivity, educational materials, and other related areas. Results: Despite multiple challenges ‘Closing the Gap' programs are having an impact in reducing health disparities in diabetes, cardiovascular diseases, cancer, HIV/AIDS, adult and child immunization, maternal and infant mortality and oral health in Florida. Conclusion: Challenges are identified in data collection, strategies, uniformity, and sustainable partnerships. Along with others, more CBPR approaches and cost-effectiveness analysis components are recommended for future success.