Online Program

Evaluating the Million Hearts Learning Collaborative. Measuring and Documenting our Impact Together

Monday, November 2, 2015 : 12:30 p.m. - 1:00 p.m.

Karl Ensign, Science & Strategy, Association of State and Territorial Health Officials (ASTHO), Arlington, VA
Rebecca Brady, Planning and Evaluation, Association of State and Territorial Public Health Officials (ASTHO), Arlington, VA

The Million Hearts initiative enhances cardiovascular disease prevention activities across the public and private sectors in an unprecedented effort to prevent 1 million heart attacks and strokes by 2017. The Association of State and Territorial Health Officials’ (ASTHO) Million Hearts Learning Collaborative assists state health agencies efforts to achieve these goals. 

Sixteen state health agencies and one freely associated state territory were selected to participate in the Million Hearts Learning Collaborative. States are utilizing a quality improvement process to partner across sectors to implement evidence-based strategies to identify, control, and improve blood pressure. The teams are using the Plan, Do, Study, Act (PDSA) model to test and spread systems-level changes using the following levers: data analysis and sharing, creating community clinical linkages, and financing/reimbursement policy.

Participatory evaluation strategies were used to track the change process and measure impact.  Through an iterative process, an overarching logic model was developed with participating states, the project team and the funding agency.  Within this framework, states self-identified the portions of the logic model that reflected their specific interventions and intended outcomes.  Collaborative efforts were undertaken to standardize measurement and data reporting.  A data entry tool was developed and placed on a shared website.  This facilitated shared ownership of the evaluation as states could see both individual and collective impact. Capacity building assistance was provided with an emphasis on facilitating peer-to-peer TA.  The logic model was used as a framework for discussion and analysis within the team and across participating sites.    

There are early indications of success.  All states adopted the National Quality Forum 18 (NQF-18) blood pressure control performance measure. Participating states report affecting 90,000 patients and potentially reaching 1.5 million. In just 9 months, several clinics demonstrated improvement in the percentage of hypertensive patients under control by as much as 12 percentage points.

Learning Areas:

Chronic disease management and prevention
Conduct evaluation related to programs, research, and other areas of practice
Planning of health education strategies, interventions, and programs
Public health administration or related administration

Learning Objectives:
Discuss the objectives and process of this national, collaborative initiative. Describe the participatory methods used to define the evaluation framework. Explain the tools used to enhance collaborative measurement and data entry. Analyze the collective impact of participating states and territories. Assess lessons learned for the evaluation field.

Keyword(s): Evaluation, Hypertension

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been the principal of many federal and state funded grants focused on evaluating public health and social services delivery systems, services and programs. My scientific interests include the development of participatory evaluation strategies and evaluating complex systems change initiatives. Other areas include performance measurement and management, return on investment (ROI), and strategic planning.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.