Promising community-level indicators for evaluating cardiovascular health-promotion programs

Rigorous evaluation of community-based programs can be costly, particularly when a representative sample of all members of the community are surveyed in order to assess the impact of a program on individual health behavior, C ommunity-level indicators (CLIs), which are based on observations of aspect s of the community other than those associated with individuals, may serve to supplement individual-level measures in the evaluation of community-base d programs or in some cases provide a lower-cost alternative to individual- level measures, Because they are often based on observations of the communi ty environment, CLIs also provide a way of measuring environmental changes - often an intermediate goal of community-based programs, The Centers for D isease Control and Prevention convened a panel of experts knowledgeable abo ut community-based program evaluation and cardiovascular disease (CVD) prev ention to develop a list of CLIs, and rate their feasibility, reliability a nd validity, The indicators developed by the panel covered tobacco use, phy sical activity, diet and a fourth group that were considered 'cross-cutting ' because they related to all three behaviors, The indicators were subdivid ed into policy and regulation, information, environmental change, and behav ioral outcome, For example, policy and regulation indicators included laws and ordinances on tobacco use, policies on physical education, and guidelin es for menu and food preparation, These indicators provide a good starting point for communities interested in tracking CVD-related outcomes at the co mmunity level.