Findings from a cross-site evaluation of a rural Georgia health equity initiative
Abstract
Healthcare Georgia Foundation developed The Two Georgias Initiative to address health inequities in rural Georgia. From 2017-2022, 11 rural health coalitions received funding and technical support to plan and implement strategies to address local health equity issues. The cross-site evaluation of the Initiative answered key evaluation questions that aligned with Foundation goals for the Initiative. This presentation will describe cross-site evaluation design and key findings drawing from five years of evaluation data. The evaluation plan included seven process evaluation questions and four outcome evaluation questions. Process questions explored coalition characteristics, major barriers and facilitators to success, coalition functioning, strategies implemented and their reach to prioritized populations, support services provided, and steps taken to ensure sustainability. Outcome questions examined changes in community readiness and capacity to address health equity, organizational capacity to address health equity, equity outcomes achieved, and aspects of the initiative to be sustained. Our mixed-methods approach to data collection used several qualitative and quantitative data sources. We conducted annual key informant interviews (n=119) with coalition leaders to learn about coalition processes and implementation steps. We surveyed coalition members pre- and post- implementation (n=494) to understand coalition member engagement and accomplishments. We mailed pre- and post- implementation surveys to randomly selected households to understand residents’ perceptions of health supporting environments and selected health behaviors and outcomes (baseline n=2,788; follow-up n pending). We developed a community change tracking tool to document policy, system, and environmental changes in each coalition community (n=11). Findings will be presented in 5 sections: 1) coalition formation and functioning, 2) community readiness and capacity to address health equity, 3) contextual factors (e.g., barriers and facilitators to success), 4) community changes to promote health equity, and 5) sustainability of coalitions and strategies. Conclusions, lessons learned, and recommendations for implementers and evaluators of similar initiatives will be shared.
Keywords
rural, health equity, coalitions, evaluation
Findings from a cross-site evaluation of a rural Georgia health equity initiative
Healthcare Georgia Foundation developed The Two Georgias Initiative to address health inequities in rural Georgia. From 2017-2022, 11 rural health coalitions received funding and technical support to plan and implement strategies to address local health equity issues. The cross-site evaluation of the Initiative answered key evaluation questions that aligned with Foundation goals for the Initiative. This presentation will describe cross-site evaluation design and key findings drawing from five years of evaluation data. The evaluation plan included seven process evaluation questions and four outcome evaluation questions. Process questions explored coalition characteristics, major barriers and facilitators to success, coalition functioning, strategies implemented and their reach to prioritized populations, support services provided, and steps taken to ensure sustainability. Outcome questions examined changes in community readiness and capacity to address health equity, organizational capacity to address health equity, equity outcomes achieved, and aspects of the initiative to be sustained. Our mixed-methods approach to data collection used several qualitative and quantitative data sources. We conducted annual key informant interviews (n=119) with coalition leaders to learn about coalition processes and implementation steps. We surveyed coalition members pre- and post- implementation (n=494) to understand coalition member engagement and accomplishments. We mailed pre- and post- implementation surveys to randomly selected households to understand residents’ perceptions of health supporting environments and selected health behaviors and outcomes (baseline n=2,788; follow-up n pending). We developed a community change tracking tool to document policy, system, and environmental changes in each coalition community (n=11). Findings will be presented in 5 sections: 1) coalition formation and functioning, 2) community readiness and capacity to address health equity, 3) contextual factors (e.g., barriers and facilitators to success), 4) community changes to promote health equity, and 5) sustainability of coalitions and strategies. Conclusions, lessons learned, and recommendations for implementers and evaluators of similar initiatives will be shared.
