Division for Heart Disease and Stroke Prevention - State Program, Evaluation Guides

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State Program Evaluation Guides

Purpose

The Heart Disease and Stroke Prevention (HDSP) Program Evaluation Guides are a series of evaluation technical assistance tools developed by the Centers for Disease Control and Prevention (CDC), Division for Heart Disease and Stroke Prevention, to assist in the evaluation of heart disease and stroke prevention activities within states.

The guides are intended to offer guidance, consistent definition of terms, and aid skill building on a wide range of general evaluation topics and selected specific topics. They were developed with the assumption that state health departments have varied experience with program evaluation and a range of resources allocated to program evaluation. In any case, these guides clarify approaches to and methods for evaluation, provide examples specific to the scope and purpose of the state HDSP programs, and recommend resources for additional reading. Some guides will be more applicable to evaluating capacity building activity and others more focused on interventions. Although examples provided in the guides are specific to HDSP programs, the information might also prove valuable to other state health department programs, especially chronic disease programs.

Background

Heart disease and stroke, the primary components of cardiovascular disease (CVD), are leading causes of death and disability in the United States. As the burden of heart disease and stroke continues to increase, these conditions are projected to remain the number one and two causes of death worldwide through the year 2020. In the United States alone, CVD affects 61.8 million Americans and claims nearly 1 million lives annually among people of all racial/ethnic groups and ages.

In 1998, the U.S. Congress provided funding for CDC to initiate a national, state-based heart disease and stroke prevention program. As of July 2007, CDC funds heart disease and stroke prevention programs in 33 states and the District of Columbia. The priority areas for State activities are:

Increase control of high blood pressure.

Increase control of high cholesterol.

Increase awareness of signs and symptoms of heart attack and stroke and the need to call 9–1–1.

Improve emergency response.

Improve quality of care.

Eliminate disparities.

Many factors increase the risk of developing heart disease and stroke. State-based programs must therefore use strategies that target multiple risk factors in many different settings, including health care settings, work sites, communities, and school worksites to be effective.

States are encouraged to build capacity, use evidence-based approaches when they exist, and develop innovative interventions to address heart disease and stroke prevention. CDC-funded states are charged with providing evidence of capacity, of intervention, and of change within their state and are encouraged to build evidence for innovative and promising practices.

In 2003, CDC convened key public health partners, including state programs, to develop A Public Health Action Plan to Prevent Heart Disease and Stroke. The Action Plan identifies targeted recommendations and specific action steps necessary to reduce the health and economic toll caused by heart disease and stroke and supports the identification of innovative ways to monitor and evaluate policies and programs. The Action Plan is available online at http://www.cdc.gov/DHDSP/library/action_plan/index.htm.

Using the Guides

The guides are intended to be companion pieces to existing program evaluation documents. The CDC State Heart Disease and Stroke Prevention Program Evaluation Framework is located on the Internet at http://www.cdc.gov/DHDSP/library/evaluation_framework/index.htm.

The guide topics are divided broadly into two categories, fundamentals and capacity building- or intervention-related. The guides in the fundamentals series will be completed first and will cover general evaluation topics using specific HDSP examples.

Capacity building- and intervention-related guides will provide the tools and techniques to evaluate capacity building activities, like the effectiveness of partnerships, and interventions in the health care, work site, and community settings. Some of the guides will be developed for evaluations of specific interventions and others will focus on tools for evaluating interventions.

Because states have different levels of experience and involvement with evaluation, the series of guides will range from very basic to more advanced topics. Depending on the evaluation capacity of state programs, some guides will be more useful to program staff than others.

The guides are expected to be distributed over time. State programs should review the guides as they are distributed and determine which are most applicable given current resources and activities. The series will be expanded and enhanced as additional needs are identified and as state evaluation capacity is increased. States are encouraged to provide feedback to the Evaluation Team on the utility of guides and suggested topics for future guides.

Evaluation Guides