Social Determinants of Health: Applying Leading, National Frameworks to Construct a Story of Place

Abstract Information: Evaluators who work at the community level to address the social determinants of health need to understand and engage community members to ensure that their stories help to drive our processes and interpretations. We strive to be equitable as well as respectful to community members and to advance the common good. A number of national frameworks and models that can help guide evaluators’ work with historically disenfranchised communities have emerged over the past 10 years. This session will review the key frameworks employed at The Leonard Parker Pool Institute for Health, whose vision is to provide meaningful and sustained improvements in overall health through innovations targeting key issues affecting our region. We will discuss the ways that we apply the principles of the frameworks as we embark on a long-term initiative to improve the health and education outcomes of people living in a specific community where there are significant disparities as well as a readiness for meaningful community development investments. Eight national models/frameworks will be reviewed along with their associated tools. The BUILD Health Challenge, The Build Healthy Places Network, Enterprise Community Partners, Focused Community Strategies, Strive Together, Purpose-Built Communities, Well-Being in the Nation, and The Rippel Foundation have all developed upstream, place-based approaches to addressing community factors that shape health equity and disparities.  We will show how we are applying the tools and concepts of these models and frameworks to improve outcomes in our community.

Relevance Statement: Community development evaluation work is complicated. It presents many challenges to the evaluator including the number and variety of stakeholders that need to be included, the complexity of working with multiple sectors simultaneously, and the time it takes to realize fundamental changes at the community level. As we know from Michael Quinn Patton (2011), communities are complex, and complex situations are often best evaluated by taking a developmental approach. In developmental evaluation, the evaluator captures “lessons about what is being learned over time and then uses those cumulative learnings to support and inform ongoing development” (p. 234). Community-level evaluation requires both population-level benchmarks and shorter-term proximal indicators to check progress along the way and drive decisions about what interventions might be most effective. Longer-term outcomes of our work include things such as the effectiveness of the community infrastructure and the level of engagement. As we work toward maximizing those, we will need to determine how resources are distributed across the community and how resources match the needs of community members. We will discuss how we leverage existing community connections as a way to assist with gathering authentic stories from the community to help drive our processes. This presentation will provide frameworks and tools that can be used by evaluators who are working at the community level. Attendees will find value in our review of leading frameworks for community development work. We will clarify the main concepts,of eight national frameworks that audience members can use to guide and evaluate their community development work. We will discuss how we are using these models to help define, operationalize, and evaluate complex factors such as equity, community infrastructure, and community engagement. Reference Patton, M.Q. (2011). Developmental evaluation: Applying complexity concepts to enhance innovation and use. London: Guilford Press.