Tools to evaluate policy and environmental changes:

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Tools to evaluate policy and environmental
changes

• Opportunities for growing the field

Presented by Laura K. Brennan, PhD, MPH
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Our Team Partners

• Robert Wood Johnson Foundation
• Tracy Orleans, Laura Leviton (and Punam
  Ohri-Vachaspati)
• Active Living By Design
• Sarah Strunk, Phil Bors, Rich Bell, Fay Gibson,
  Joanne Lee, Mary Beth Powell, Tim Schwantes, Risa
  Wilkerson
• Community Partnerships (25 ALbD, 50 Healthy Kids,
  Healthy Communities)
• Washington University Institute for Public Health
  (St. Louis)
• Ross Brownson, Cheryl Carnoske, Christy Hoehner,
  Peter Hovmand, Timothy Hower
• Saint Louis University School of Public Health
• Elizabeth Baker, Cheryl Kelly
• Transtria LLC
• Tammy Behlmann, Sarah Castro, Julie Claus, Peter
  Holtgrave, Courtney Jones, Allison Kemner, Laura
  Runnels (many part-time staff and interns)

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Healthy Kids, Healthy Communities (50 Grantees)
HKHC Leading Site Communities
Seattle/King County, WA
Portland/Multnomah County, OR
Houghton, MI
Benton County, OR
Fitchburg, MA
Rochester, NY
Milwaukee, WI
Buffalo, NY
Somerville, MA
Kingston, NY
Flint, MI
Kane County, IL
Philadelphia, PA
Chicago, IL
Omaha, NE
Oakland, CA
Hamilton County, OH
Washington, DC
Denver, CO
Watsonville/Parajo Valley, CA
Kansas City, MO
Charleston, WV
Central Valley, CA
Columbia, MO
Louisville, KY
Nash/Edgecombe Counties, NC
Cuba, NM
Baldwin Park, CA
Knoxville, TN
Moore/Montgomery Counties, NC
Rancho Cucamonga, CA
Chattanooga, TN
Boone/Newton Counties, AR
Greenville, SC
San Felipe Pueblo, NM
Spartanburg, SC
Jefferson County, AL
Desoto/Marshall/ Tate Counties, MS
Phoenix, AZ
Milledgeville, GA
Grant County, NM
Jackson, MS
Cook County, GA
El Paso, TX
New Orleans, LA
San Antonio, TX
Duval County, FL
Houston, TX
Lake Worth/Greenacres/ Palm Springs, FL
Caguas, PR
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Our Advisors

• National Policy/Practice Advisory Group
• Don Bishop
• Elaine Borton
• Leah Ersoylu
• Steve Farrar
• Harold Goldstein
• Dean Grandin
• James Krieger
• Elizabeth Majestic
• Jacqueline Martinez
• Malisa McCreedy
• Leslie Mikkelsen
• Joyal Mulheron
• Thomas Schmid
• Marion Standish
• Ian Thomas
• Mildred Thompson

• National Research Advisory Group
• Elizabeth Baker
• Rachel Ballard-Barbash
• Frank Chaloupka
• William Dietz
• Lawrence Green
• Terry Huang
• Shiriki Kumanyika
• Marc Manley
• Robin McKinnon
• Shawna Mercer
• Meredith Reynolds
• Barbara Riley
• Eduardo Sanchez
• Loel Solomon

• National Working
• Group
• Karen Glanz
• Debra Haire-Joshu
• Laura Kettel-Khan
• Maya Rockeymoore
• James Sallis
• Janice Sommers
• Mary Story
• Sarah Strunk
• Antronette Yancey

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Our Projects
Projects Brief Description
Social determinants of health (2003-2010) Funding Centers for Disease Control Prevention Process Forum, Presentation, Application Products Workbook, Training, Train-the-trainer
Evaluation of Active Living by Design (2006-2010) Funding Robert Wood Johnson Foundation Process Interviews/Site visits Products Journal Supplement, Case Reports
Review of environment policy interventions for childhood obesity prevention (2008-2011) Funding Robert Wood Johnson Foundation Process Advisors, Resource review Products Intervention strategy summaries, Gaps
Evaluation of Healthy Kids, Healthy Communities (2009-2014) Funding Robert Wood Johnson Foundation Process Technical assistance, Interviews/Site visits Products Articles, Policy Briefs, Resources, Tools
System dynamics modeling to inform overweight and obesity-relevant policy (2009-2011) Funding National Institutes of Health Process Group model building Products System dynamics models
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Connecting Projects

• Bridge research/evaluation and policy/practice
• Evaluate system, policy and environment change
  impacts and outcomes
• Assess reach, adoption, implementation and
  sustainability of policy and environment
  interventions
• Accelerate translation of replicable,
  evidence-based policy and environment
  interventions
• Model the complex pathways from community
  contextual factors to behaviors and health

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Why Evaluate?
Green LW. Making research relevant if it is an
evidence-based practice, wheres the
practice-based evidence? Family Practice 2008
1-5.
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Why Evaluate?
Building the scientific evidence
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Why Evaluate?
Shaping, creating policies and practices for the
field
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Why Evaluate?
Chances of sustainability are higher for projects
that have been evaluated
Stevens B, Peikes D. When the funding stops Do
grantees of the Local Initiative Funding Partners
Program sustain themselves? Evaluation and
Program Planning 2006 29 (2) 153-161.
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Why Evaluate?

• To determine the effectiveness of local policy,
  environment, and system changes
• To identify the changes with the greatest impact,
  relevance, feasibility and sustainability
• To inform local decision-making, document
  successes obtain more funding
• THESE ARE NOT MUTUALLY EXCLUSIVE

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Why Evaluate?

• To determine the effectiveness of local policy,
  environment, and system changes
• Short-, intermediate- long-term health behavior
  or obesity outcomes
• Reliable valid quantitative tools measures
• Study design and execution to ensure confidence
  in the findings

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Why Evaluate?

• To determine the effectiveness of local policy,
  environment, and system changes
• Short-, intermediate- long-term health behavior
  or obesity outcomes
• Reliable valid quantitative tools measures
• Study design and execution to ensure confidence
  in the findings
• OPPORTUNITY
• What is a meaningful decrease in BMI? Increase in
  activity? Decrease in sugar consumption?

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Why Evaluate?

• To determine the effectiveness of local policy,
  environment, and system changes
• Short-, intermediate- long-term health behavior
  or obesity outcomes
• Reliable valid quantitative tools measures
• Study design and execution to ensure confidence
  in the findings
• OPPORTUNITY
• Should we use height/weight (BMI)? skinfold
  thickness? waist circumference? accelerometers?
  3-day food recall interviews? surveys?

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Why Evaluate?

• To determine the effectiveness of local policy,
  environment, and system changes
• Short-, intermediate- long-term health behavior
  or obesity outcomes
• Reliable valid quantitative tools measures
• Study design and execution to ensure confidence
  in the findings
• OPPORTUNITY
• Prospective cohort designs? Complex time series
  designs? Natural experiments? What is the
  intervention population? What is a representative
  evaluation population?

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Why Evaluate?

• To identify approaches with the greatest impact,
  relevance, feasibility and sustainability
• What works, where it works, when it works, how it
  works why it works (or why not)
• Multi-method quantitative qualitative measures
• Local representation and participation to ensure
  confidence in the findings

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Why Evaluate?

• To identify approaches with the greatest impact,
  relevance, feasibility and sustainability
• What works, where it works, when it works, how it
  works why it works (or why not)
• Multi-method quantitative qualitative measures
• Local representation and participation to ensure
  confidence in the findings
• OPPORTUNITY
• Partnership or coalition formed? New
  decision-making body or position created? Policy
  developed? Policy adopted? Funds appropriated?
  New/improved structures, facilities or
  conditions? Policy compliance? Policy
  enforcement? Use of new facilities? Maintenance
  of new facilities?

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Why Evaluate?

• To identify approaches with the greatest impact,
  relevance, feasibility and sustainability
• What works, where it works, when it works, how it
  works why it works (or why not)
• Multi-method quantitative qualitative measures
• Local representation and participation to ensure
  confidence in the findings
• OPPORTUNITY
• Should we use policy assessment? environmental
  audits? direct observation? key informant
  interviews? focus groups? surveys? photovoice or
  digital storytelling? GIS mapping? web-based
  tracking systems?

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Why Evaluate?

• To identify approaches with the greatest impact,
  relevance, feasibility and sustainability
• What works, where it works, when it works, how it
  works why it works (or why not)
• Multi-method quantitative qualitative measures
• Local representation and participation to ensure
  confidence in the findings
• OPPORTUNITY
• (Perspective of community members) Does the
  policy or environmental change increase access to
  healthy foods or opportunities for physical
  activity? Did community members participate in
  planning, implementation and evaluation? Can the
  community sustain the changes over time?

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Why Evaluate?

• To inform local decision-making, document
  successes obtain more funding
• Track unintended results practical
  considerations (resources, costs, assets
  challenges)
• Simple, quick measures serving multiple purposes
  (advocacy, marketing, cost savings)
• Findings respond to the interests of local
  audiences (decision-makers, business owners)

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Why Evaluate?

• To inform local decision-making, document
  successes obtain more funding
• Track unintended results practical
  considerations (resources, costs, assets
  challenges)
• Simple, quick measures serving multiple purposes
  (advocacy, marketing, cost savings)
• Findings respond to the interests of local
  audiences (decision-makers, business owners)
• OPPORTUNITY
• Who did the work? For how long? Who provided
  resources? How much did it cost? What funding was
  provided/leveraged? What were unanticipated
  benefits/challenges?

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Why Evaluate?

• To inform local decision-making, document
  successes obtain more funding
• Track unintended results practical
  considerations (resources, costs, assets
  challenges)
• Simple, quick measures serving multiple purposes
  (advocacy, marketing, cost savings)
• Findings respond to the interests of local
  audiences (decision-makers, business owners)
• OPPORTUNITY
• What policy assessment tools inform policy
  development? What audit tools can be used to
  increase awareness? Can digital storytelling be
  used for advocacy? What surveys help to estimate
  costs?

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Why Evaluate?

• To inform local decision-making, document
  successes obtain more funding
• Track unintended results practical
  considerations (resources, costs, assets
  challenges)
• Simple, quick measures serving multiple purposes
  (advocacy, marketing, cost savings)
• Findings respond to the interests of local
  audiences (decision-makers, businesses, schools,
  residents)
• OPPORTUNITY
• What are the costs? What are the impacts on
  economic development, academic performance,
  community safety or air quality? Are changes
  implemented and enforced equitably throughout the
  community?

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Evidence

• With expanded definitions of evidence, answers to
  these questions help to
• bridge the gap between
• research/evaluation and
• policy/practice efforts

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Shaping the Field
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Evaluation Beginning to End
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Evaluation Beginning to End

• Connect the intervention and evaluation
• Work plan and logic model
• Determine the evaluation approach
• Participatory, communities, strategies
• Use multi-method quantitative qualitative
  measures
• Reliability, validity, feasibility
• Seek partners for data collection data analysis
• Existing data, new data
• Translate and disseminate findings
• Audience, content, medium

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Evaluation Beginning to End

• Connect the intervention and evaluation
• Work plan and logic model
• Determine the evaluation approach
• Participatory, communities, strategies
• Use multi-method quantitative qualitative
  measures
• Reliability, validity, feasibility
• Seek partners for data collection data analysis
• Existing data, new data
• Translate and disseminate findings
• Audience, content, medium

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Work Plan

• Planning
• Goals
• Objectives
• Activities
• Implementation
• Events
• Actions
• Evaluation
• Outcomes
• Impacts
• Processes

Goal Broad outcomes partners hopes to achieve aligned with the overall purpose of the project. Goal Broad outcomes partners hopes to achieve aligned with the overall purpose of the project. Lead Assessment/ Evaluation
Objective More specific strategies/ methods aligned with and used to help achieve a goal (or related goals). Individual or group to complete a goal, objective or activity. Indicators that the goal has been reached, the objective accomplished or the activity implemented.
Activity Planned events or efforts to help achieve the objective(s). Individual or group to complete a goal, objective or activity. Indicators that the goal has been reached, the objective accomplished or the activity implemented.
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Work Plan
Goal Adopt and implement a Complete Streets policy Goal Adopt and implement a Complete Streets policy Lead Assessment/ Evaluation
Objective By June 2010, develop the components of a Complete Streets policy (e.g., sidewalk, bike lane, and crosswalk parameters). Pedestrian/ Bicyclist committee Complete Streets policy adopted by City/ implemented by x of neighborhoods Condition of sidewalks, bike lanes, and crosswalks (before and after policy) Number and type of participants attending the Summit
Activity Host a Complete Streets Summit that invites stakeholders from neighborhoods Pedestrian/ Bicyclist committee Complete Streets policy adopted by City/ implemented by x of neighborhoods Condition of sidewalks, bike lanes, and crosswalks (before and after policy) Number and type of participants attending the Summit

• Planning
• Goals
• Objectives
• Activities
• Implementation
• Events
• Actions
• Evaluation
• Outcomes
• Impacts
• Processes

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Work Plan
Goal Plan/organize/ implement a Corner Store Initiative Goal Plan/organize/ implement a Corner Store Initiative Lead Assessment/ Evaluation
Objective By October 2010, identify 5 local farmers (producers) and 5 convenience stores (retailers) to improve access to healthy foods/beverages Food Policy Council Sales and profits on healthy, locally grown foods/beverages Number of corner stores and local farms participating Cost, placement and marketing of foods/beverages Start-up and maintenance costs (e.g., refrigeration)
Activity Create a plan for food distribution and storage (farmers to stores) and a business model for profit sharing Food Policy Council Sales and profits on healthy, locally grown foods/beverages Number of corner stores and local farms participating Cost, placement and marketing of foods/beverages Start-up and maintenance costs (e.g., refrigeration)

• Planning
• Goals
• Objectives
• Activities
• Implementation
• Events
• Actions
• Evaluation
• Outcomes
• Impacts
• Processes

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Logic Models

• What is a logic model?
• Description of how activities to be carried out
  during a project are related to the expected
  outcomes
• Five core components
• Inputs resources, contributions, investments
• Activities actions, events
• Outputs immediate products (trained staff,
  meeting attendees)
• Outcomes changes related to your objectives
• Impacts changes related to your goals
• Other considerations
• Assumptions, External or Contextual Factors
  beliefs about the people involved, interactions
  and influence of the environment, political
  context, social determinants of health

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Evaluation Beginning to End

• Connect the intervention and evaluation
• Work plan and logic model
• Determine the evaluation approach
• Participatory, communities, strategies
• Use multi-method quantitative qualitative
  measures
• Reliability, validity, feasibility
• Seek partners for data collection data analysis
• Existing data, new data
• Translate and disseminate findings
• Audience, content, medium

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Evaluation Approach
Participatory evaluation External evaluation
Who? All partners engaged in planning, implementation, enforcement sustainability Objective, third party typically having some research or evaluation expertise
How? Collective planning and decision-making Simple, interactive and engaging process Tracking and monitoring to inform local efforts Reliable and valid measurement tools Multiple methods and measures High-quality design and execution of methods
When? Throughout the entire process, meaningful findings for all partners Strategic points during intervention (baseline, midpoint, follow-up)
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Evaluation Approaches
Example Evaluation Methods Example Strategies Example Strategies Example Strategies
Example Evaluation Methods Complete Streets Farmers Markets Childcare Curriculum
Policy Analysis SITES TOOLS SITES TOOLS SITES TOOLS
Environmental Audits SITES TOOLS SITES TOOLS SITES TOOLS
Direct Observation SITES TOOLS SITES TOOLS SITES TOOLS
GIS Mapping SITES TOOLS SITES TOOLS SITES TOOLS

• Understanding system, policy and environment
  impacts
• Similar settings, approaches and strategies
• Common tools and/or measures

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Evaluation Beginning to End

• Connect the intervention and evaluation
• Work plan and logic model
• Determine the evaluation approach
• Participatory, communities, strategies
• Use multi-method quantitative qualitative
  measures
• Reliability, validity, feasibility
• Seek partners for data collection data analysis
• Existing data, new data
• Translate and disseminate findings
• Audience, content, medium

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Multi-method
Methods Description (examples)
Direct observation Record of people, selected characteristics (age, gender), and behaviors (use of facilities, food purchases) for specific locations and time periods
Audit/Photo/Video Unobtrusive assessment of factors in the physical or social environment that can hinder or facilitate behavior (playground, menu boards)
Policy analysis Inventory of existing policies, modified policies or new policies (nutrition standards, time for activity), also implementation and enforcement
GIS mapping Spatial relationships using surveillance data and sophisticated software programs (location of fast food restaurants, streets with bike lanes)
Interview/ Focus group Open-ended questions to partners, staff, decision-makers and community members (access to healthy foods or places to be active)
Survey Close-ended questions to partners, staff, decision-makers and community members (perceptions of policy and environment changes)
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Direct Observation
Strengths () Pre/post comparison () Evaluates
the impact of physical changes or improvements on
behavior
Challenges (-) May depend on external factors
(e.g., weather, special events) (-) Requires many
observations (times of day, days of week)
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Environmental Audits
Strengths () Validated tools () Pre/post
comparison () Impact of policies or physical
projects on environmental conditions
Challenges (-) May not compare across different
communities or physical projects (-) May not have
facilities or environments to audit at baseline
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Photos Videos
Strengths () Provides visual representation of
project impacts () Conveys project impacts to
diverse audiences
Challenges (-) May be expensive depending on
equipment and production (-) Requires consent for
photo release
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Policy Analysis
CDC Community Health Assessment aNd Group
Evaluation (CHANGE) Tool
Strengths () Identifies policies that hinder or
support healthy eating or active living () Tools
provide potential policies for planning/
implementation
W. K. Kellogg Food Fitness Planning Guide
http//www.cdc.gov/healthycommunitiesprogram/tools
/change.htm
YMCAs Community Healthy Living Index (CHLI)
Challenges (-) May not capture practices
(informal policies) (-) May not track policy
development, implementation or enforcement
http//ww2.wkkf.org/DesktopModules/WKF.00_DmaSuppo
rt/ViewDoc.aspx?LanguageID0CID6ListID28ItemI
D5000564fldPDFFile
http//www.ymca.net/communityhealthylivingindex/to
ols.html
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GIS Mapping
Strengths () Provides visual representation
multiple data sources (triangulation) () Conveys
project impacts to diverse audiences
Challenges (-) May be expensive (data
software) (-) May be difficult to access data (-)
May not have current or accurate data
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Interview
What staff (time, expertise, training), resources
(space, equipment) and funding were needed?
Strengths () Gathers what, who, where, when,
how, and why responses () Captures emotional
responses () Offers flexibility to clarify or
probe in areas of interest
Has their been support from elected officials or
community leaders?
Challenges (-) May be time intensive (-) Reflects
only one perspective (-) Requires expertise or
experience in areas of interest
What plans have been made sustain the efforts
over time?
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Focus Group
How did your partnership get the community
involved in its efforts?
Strengths () Gathers what, who, where, when,
how, and why responses () Captures social and
emotional responses () Offers flexibility to
clarify or probe in areas of interest () Obtains
multiple perspectives () Generates new ideas or
questions
What are barriers to healthy eating and active
living in your community?
Challenges (-) May be time intensive (-) May
require travel (in-person) (-) May be restricted
to only a few topics rather than a broad spectrum
of topics
What has made the initiative successful in your
community?
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Survey
Strengths () May require few resources for data
collection or analysis () Enables site and
cross-site analysis of responses
Active Living Research
http//www.activelivingresearch.org/
Healthy Eating Research
Challenges (-) Limits the amount of detail and
nuances across efforts that can be captured (-)
May require multiple or long surveys for the
range of activities conducted
http//www.healthyeatingresearch.org/
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Web-based tracking system
Strengths () Focuses on goals, tactics, and
benchmarks created by the communities () Keeps a
log of all activities conducted
Challenges (-) May be time intensive (-)
Development can be expensive (-) Depends on
quality/ complete entries (-) Requires expertise
for categorizing entries
http//www.healthykidshealthycommunities.org
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Evaluation Beginning to End

• Connect the intervention and evaluation
• Work plan and logic model
• Determine the evaluation approach
• Participatory, communities, strategies
• Use multi-method quantitative qualitative
  measures
• Reliability, validity, feasibility
• Seek partners for data collection data analysis
• Existing data, new data
• Translate and disseminate findings
• Audience, content, medium

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Evaluation Partners

• Increase evaluation capacity
• Co-design evaluation and dissemination activities
• Build on existing social relationships to solicit
  participation from people and organizations
• Determine assets/barriers of people (e.g.,
  knowledge, skills), organizations (e.g., public
  health agencies) and infrastructures (e.g.,
  parks, grocery stores) in the community
• Create collaborative processes to engage
  communities in joint decision-making
• Support for tool selection, data collection
  data analysis
• Seek technical assistance for assessment
  evaluation
• Document intended/unintended consequences
• Identify pathways, strengths and challenges

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Partnership
Base Model
Collaboration Model
Lead Agency Model
Utilitarian Model
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Evaluation Beginning to End

• Connect the intervention and evaluation
• Work plan and logic model
• Determine the evaluation approach
• Participatory, communities, strategies
• Use multi-method quantitative qualitative
  measures
• Reliability, validity, feasibility
• Seek partners for data collection data analysis
• Existing data, new data
• Translate and disseminate findings
• Audience, content, medium

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With Partners

• Reassess your partnership structure
• Create local awareness of the partnership
• Bring in new partners
• Ensure active participation
• Encourage shared leadership and decision-making
• Develop a strong sense of group identity
• Create partnership principles or agreements
• Develop partners skills and leverage resources
• Recognize the efforts of your partners

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With Communities

• Increase community awareness of the policy or
  environment changes
• Share lessons learned with similar groups
• Gain support for future efforts (political or
  community support)
• Build on existing efforts and recognize new
  efforts
• Identify potential new sources of funding

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Other Related Efforts

• Measures Registry (subcontract with Mathematica)
• Energy Gap Modeling (Gortmaker Wang)
• Developing an Evidence-Based Intervention
  Planning System for Obesity Prevention (NIH SBIR)

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Laura K. Brennan, PhD, MPH laura_at_transtria.com
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Washington State Healthy Communities Assessment
Workbook Marilyn Sitaker, MPH
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What is the Washington Healthy Communities
Project?

• Who Washington State Department of Health
  programs that address chronic diseases and their
  risk factors
• What Build capacity of local health
  jurisdictions (LHJs) to address primary risk
  factors for chronic diseases tobacco, nutrition,
  and physical activity
• How Change local policies, environments, and
  systems where people live, work, play, and go to
  school
• 5 LHJs were chosen based on their high levels of
  risk, low resource level, and willingness.

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The Washington Healthy Communities Initiative
building local capacity

• Capacity building consists of
• Technical assistance tailored to each LHJ
• Series of skill-building trainings
• Policy environmental change approach
• Community assessment
• Building local partnerships
• Developing action plans
• Data tools to support assessment and planning

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Timeline for HC Initiative
July 2009 December 2010
DOH Planning Begins
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Assessment Package Factors to Consider

• Communities did not have time or skills to
  collect and analyze lots of datatherefore, DOH
  had to provide a clear assessment framework and
  give communities as much pre-analyzed data as
  possible.
• Identify a set of core indicators for critical
  features of the built environment data sources
  available state-wide
• Main focus building skills in interpreting,
  synthesizing, and connecting data to appropriate
  evidence-based intervention strategies.

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Choosing Indicators, Finding Data

• Recommended Community Strategies
  Measurements to Prevent Obesity in the United
  States
• MMWR July 24, 2009 / 58(RR07)1-26
• Advisory Group
• University of Washington, Center for Public
  Health Nutrition and College of Urban Planning
• DOH spatial analysis group
• State Indicator Report on Fruits and Vegetables,
  2009

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Healthy Community Assessment Workbook

• Ch 1 Describing the Burden
• Ch 2 Physical Activity
• Ch 3 Nutrition
• Ch 4 Tobacco
• Ch 5 Focus Group Guide
• Appendices Menu of Strategies
• Glossary

Features of the Built Environment
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Chapter 1 Describing the Burden

• Chronic diseases, health conditions, risk factors
  and socio- demographic data
• Graphs interpretation poverty maps

• In Grays Harbor County
• Over a third of household have income less than
  200 percent of poverty.
• 3 out of 4 adults 25 and older do not have a
  college degree.
• About a 14 percent of the population is non-white
  or Hispanic.
• Slightly less than a third of adults have no
  medical insurance.

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Chapters 2-4 Local Environment

• Maps of built environment features
• Data collection tools instructions
• Physical Activity
• Nutrition
• Tobacco
• Worksheets for Chapters 2 -4
• Summarize, synthesize interpret findings

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Chapters 2-4, Built Environment A. Maps
Statistics

• Physical Activity
• of city residences within ½ mile of a park,
  trail or school playground
• Nutrition
• residences in a census block within ½ mile of
  healthy food retailer
• Tobacco
• Tobacco retailers within 1,000 feet of school,
  park or clinic

Each map included a key, tech notes
interpretation
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Chapters 2-4, Built Environment B. Data
Collection Tools

• Physical Activity
• Walkability/bikeability audit
• Inventory of low-cost programs (adapted from
  RALA)
• Nutrition
• Grocery store assessment (adapted from NEMS)
• Inventory of community gardens, CSAs food banks
• Tobacco
• Policies for tobacco-free campus

Each tool included instructions for collecting,
analyzing interpreting the data
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Chapters 2-4, Built Environment C. Summary
Worksheets

• A. Data Summary, Physical Activity Environments
• What areas in your town lack parks, trails, and
  playgrounds?
• Summarize gaps in the availability of physical
  activity programming.
• Summarize problems identified during your
  walkability assessment
•  B. How data from three sources fit together
• How does the map of outdoor recreational
  facilities correspond to the poverty map in
  Chapter 1?
• What areas in your town are far away from
  low-cost physical activity programs? Are these
  areas also far away from parks, trails and
  playgrounds?
• Are there any other barriers to accessing these
  resources? This might be a good question to
  explore in your community focus group.

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LHJ Response to Assessment Workbooks

• Assessment Training
• Assessment Workbook for each LHJ
• Training for Action Planning
• LHJs shared their A-ha moments
• Formal Evaluation in progress

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Acknowledgements

• Washington State Department of Health
• Dennis McDermot , Mike Boysun, Nguyet Tran,
  Shanae Williams, Angela Kemple, and Craig
  Erickson
• University of Washington
• Colin Rehm and Phil Hurvitz
• Centers for Disease Control and Prevention
• Dr. Latetia Moore

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THANKS!

• Marilyn Sitaker
• Washington State Department of Health
• Chronic Disease Prevention Unit
• 360-236-3463
• marilyn.sitaker_at_doh.wa.gov