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DO THE BYI *CHATS HAVE THE CAPACITY TO BUILD HEALTH?

Evaluation-Report-Highlights-v2-2

HIGHLIGHTS: Backyard Initiative Evaluation Report

NOTE: “Evaluation” is often considered to be something that is done AFTER a project or program has been completed. The BYI is evaluating as the work unfolds. This allows the teams doing the work of the BYI to tweak and improve in order to increase the impact of the health improvement efforts on residents of the BYI area. .

Program Evaluation and the Backyard Initiative

From the field of program evaluation, the Backyard Initiative (BYI) is seen as a community-building enterprise in which residents who live in proximity to each other have come together as a collective to act in their shared self-interest. The Initiative sees strengthening community as the means that will lead to better resident health. The Definition of Health created by residents defines health broadly, to include social, emotional, economic, spiritual, and physical conditions.

The lead agency for the Backyard Initiative is the Cultural Wellness Center (CWC), located in the heart of the seven Minneapolis neighborhoods defining the geographical region of the Backyard. From the beginning of the BYI, the Cultural Wellness Center created and supported an infrastructure, which consists of the Community Commission on Health (Commission), Citizen Health Action Teams (CHATs), and the Community Resource Body (CRB).

By organizing residents into Citizen Health Action Teams (CHATs), each with a focus on a component affecting health, the Initiative expects to build a community that activates every resident’s concern about his or her own health, as well as the health of his or her family, and the well-being of other people. Because community building is a consensual, long-term effort, one of the keys to the Initiative’s success is cultivating and sustaining CHAT leadership and operating capacity to both implement their strategies and to move closer to having their intended impacts on community conditions to improve resident health.

The purpose of the report was to document the growth in CHAT capacity over a one-year period of time, from 2013 to 2014. However, this work is based upon earlier, foundational work conducted by the Backyard Initiative, captured in earlier phases of the evaluation..

Evaluation-Report-Highlights-v2-3BYI Evaluation Design

The Evaluation Team’s mission has been to determine the Initiative’s success with translating its concepts and principles into action with the promise of showing the community’s potential to contribute to the health of the residents in the Backyard. Following is a description of the evaluation process.

Next Steps for the Evaluation

Phases 1 – 3: reflect the Initiative’s progress with developing the infrastructure necessary to alter four conditions known to affect the health of residents: having the social support of those who care about them, feeling socially connected to a community that respects their beliefs and values, improving health literacy/education, and acquiring a sense of empowerment about personal and family health improvement.

The next phase: of the evaluation will involve interviews with community residents that are participants in CHAT activities, to ascertain the impact of the CHATs on their health and the health of their families and members of their social networks. It is believed that achieving these outcomes in Phase 4 will result in involved residents beginning an upward trajectory toward improved health, as shown in Phase 5.

Evaluation-Report-Highlights-v2-4Potential of these Results for Health Care

The implications of these community-building results for improvement of health, health care, and care costs are significant. For instance, health improvement goals requiring modification of social determinants of health and of lifestyle and behavioral change may be more easily accomplished when interventions arise from within the person’s own social networks. These same social networks informed by community-based teams could be the health care provider’s most valuable ally when care quality is hampered by lack of patient engagement. A favorable cost-to-benefit index of community-based interventions offers the prospect of generating a net savings from investment in health improvement, a needed but yet unattained feature of health care reform. These results show the first steps toward realizing the potential of community-building for health improvement.

BYI Definition of Health

  • Health is a state of physical, mental, social, and spiritual well-being. It is not only the absence of infirmity and disease.
  • Health is a state of balance, harmony, and connectedness within and between many systems – the body, the family, the community, the environment, and culture. It cannot be seen only in an individual context.
  • Health is an active state of being; people must be active participants to be healthy. It cannot be achieved by being passive.

Acknowledgements: The BYI Evaluation is commissioned by Allina Health and guided by the 35-member BYI Community Commission on Health. The report is produced in collaboration with the Cultural Wellness Center, Allina Staff, BYI members and Assessment Team and written by consultants Anu Sharma, Janice Barbee and Jerry Evans.

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