A new study from researchers at Vanderbilt and Harvard universities, published this week in the journal Health Affairs, uses federal health survey data to evaluate community-based efforts to address smoking, obesity and other health conditions such as type 2 diabetes and hypertension.
Examining health trends at the community level from 2007 to 2012, the researchers found some improvements, but no statistically significant changes in smoking, obesity or general health.
“While prior studies have focused on individuals who’ve received services through these community-based efforts, our study takes a broader approach, looking for any associated changes in population health,” said one of the authors, Dr. Melinda Buntin, professor and chair of the department of health policy at Vanderbilt University Institute for Medicine and Public Health.
“Our results suggest that benefits from these programs may take more than five years to register at the population level, and that more thorough evaluation could aid the design of future community-based efforts.”
The team sought to identify all community-based health improvement efforts receiving external funding or oversight from a national agency and relying on coordination among multiple community stakeholders, such as private industry, healthcare organizations and county health departments.
To look for associated population health changes, the authors used data from the Behavioral Risk Factor Surveillance System’s SMART data, which contains county-level data from an annual health survey of more than 400,000 randomly selected adults conducted by telephone by the Centers for Disease Control and Prevention (CDC) in partnership with all 50 states.
The analysis controlled for age, income and employment and used “statistical techniques to minimize differences between counties with and without improvement efforts. Controlling for these differences is one of the major differences between this study and previous studies of community-based efforts,” Dr. Buntin said.
According to the authors, their results suggest that community-based health improvement efforts be paired with more thorough evaluation strategies.
“What we hope to highlight through this study is not only the difficulty of conducting these types of evaluations, but also the importance and value of increased investment in the evaluation of community-based programs, including more resources for better data collection, greater involvement of evaluation scientists during implementation and longer implementation periods to assess the full impact of these programs,” said the study’s lead author, Ms. Carrie Fry, former research analyst in the department of health policy at Vanderbilt and current doctoral student in health policy.