Creating and implementing a community-engaged evaluation framework to understand and promote health equity

Background: The Health Equity Collaborative Evaluation Planning and Implementation Project (HECEPP) is a multi-partnered framework for understanding health equity in terms of evidence-based strategies designed to reduce chronic disease. Part of the North Carolina Community Transformation Grant (CTG) Project, HECEPP was solely dedicated to evaluating health equity perceptions related to three, select CTG strategies (i.e., farmers’ markets; shared use; and smoke-free multi-unit housing), making it the only project of its kind in the country.

Methods:  The HECEPP framework includes four components: community engagement (its central component); communication planning (communication processes for multi-partner information sharing); cultural competency evaluation readiness of the project team; and health equity evaluation planning. Photo elicitation sessions, key informant interviews, and a stakeholder power analysis and mapping session provided a triangulated, qualitative approach to assess community and stakeholder perceptions of health equity. 

Results: Community and stakeholder participants perceived community fit (community-defined quality, safety, values, and norms) and access (convenience, cost, safety, and awareness of products/services) as key factors in promoting health equity through the CTG strategies. Findings were presented at a town hall meeting and a county Board of Health. The HECEPP framework and findings are used as a guide for a newly formed health equity workgroup at North Carolina's department of public health.   

Conclusions:  With an emerging, national focus on equity, multi-sector partnerships, community engagement, and healthcare and community linkages, the HECEPP framework is a useful evaluation approach for establishing trust between collaborating partners, leading to in-depth understanding of, and results that promote, health equity.