Participatory Evaluation for Multisector Partnerships: Framework and Implementation Guide for Partnerships Addressing Social Determinants of Health

Abstract

The growing focus of the public health field on addressing social determinants of health (SDoH) has helped to popularize multisector, community-based partnerships as a health promotion strategy. The central premise of this strategy is that by pooling resources, skills, and knowledge, these partnerships are better equipped to address the theoretical, practical, and political challenges commonly associated with addressing social determinants of health than individual actors. However, the existing evidence for the efficacy of partnerships on improving community health outcomes is limited. Commonly used program evaluation methods and frameworks are typically designed for single interventions with proximal causal pathways and are ill-suited to evaluate the impact and success of SDOH-focused programs that involve multiple strategies with complex causal theories. Participatory evaluation is a promising alternative evaluation approach to help multisector partnerships better leverage the skills and experience of partnership members and stakeholders throughout the evaluation process. However, current participatory evaluation frameworks lack sufficient guidance on developing, implementing, and utilizing evaluations for SDoH-focused programs. The overall objective of this thesis project was to create a participatory evaluation framework for multisector partnerships working towards address social determinants of health. The first phase of this project was focused on the initial development of the evaluation framework using two primary methods: (1) a targeted literature review of commonly used evaluation frameworks for SDoH interventions and (2) key informant interviews with public health practitioners with experience working in multisector collaborations and community-based programs. The second phase of this project was the testing of this framework within a community-based multisector partnership aiming to address SDoH. This partnership includes government agencies, community-based organizations, health care organizations, and community residents. As the primary evaluator for this partnership program, I was able to assess the performance of the framework in the field. Observations and key lessons from this field implementation were used to inform the development of the Participatory Evaluation Framework for Multisector Partnerships (PEFMP) and accompanying implementation guide. As support continues to increase for multisector partnerships addressing social and structural determinants of health, there is a need for evaluation frameworks that are better suited to address their needs. The PEFMP provides the structure and processes necessary for these partnerships to utilize participatory processes to develop, implement, and utilize evaluations to better measure community impact and progress towards their shared goals.