The Kaiser Family Foundation Community Health Promotion Grants Program: Findings from an outcome evaluation

Objectives, To present results from an outcome evaluation of the Henry J. K aiser Family Foundation's Community Health Promotion Grants Program (CHPGP) in the West, which represented a major community-based initiative designed to promote improved health by changing community norms, environmental cond itions, and individual behavior in 11 western communities. Methods. The evaluation design: ill randomly assigned intervention and cont rol communities, 4 intervention communities selected on special merit, and 4 matched controls. Data for the outcome evaluation were obtained from surv eys, administered every two years at three points in time, of community lea ders and representative adults and adolescents, and from specially designed surveys of grocery stores. Outcomes for each of the 11 intervention commun ities were compared with outcomes in control communities. Results. With the exception of two intervention communities-a largely Hispa nic community and a Native American reservation-we found little evidence of positive changes in the outcomes targeted by the 11 intervention communiti es. The programs that demonstrated positive outcomes targeted dietary behav ior and adolescent substance abuse. Conclusions. improvement of health through community-based interventions re mains a critical public health challenge. The CHPGP, like other prominent c ommunity-based initiatives, generally failed to produce measurable changes in the targeted health outcomes. Efforts should focus on developing theorie s and methods that can improve the design and evaluation of community-based interventions.