Better together: Dyad structure is key in health department’s success

Evaluators find Seattle / King County Public Health nails a whopping 22 of its 24 strategies in a $25 million initiative to improve public health

• “School lunches should be healthier.”
• “People should exercise more.”
• “Policies should help people quit smoking.”

We’ve all heard maxims like these, but making these changes happen is another thing entirely. Recently, Public Health—Seattle & King County (PHSKC) was awarded $25.5 million to try to reduce obesity, tobacco use, and tobacco exposure through more than 50 separate intervention projects, which were grouped into 24 strategies. The Communities Putting Prevention to Work initiative focused on implementing changes in seven low-income communities in South Seattle / King County by promoting strategies such as healthy eating, active living, and decreasing the number of young people who start smoking and are exposed to secondhand smoke. The overarching goal was to reduce health inequities between the privileged and the disadvantaged.  

But did these changes happen? And if so, what contributed to their success? Since it is common for initiatives to assemble community stakeholders to implement policy, systems, and environment and infrastructure changes, it is vital to evaluate their implementation and impact—as well as the impact on behavior and health outcomes.

That’s just what Allen Cheadle, PhD and DeAnn Cromp, MPH from Group Health Research Institute’s Center for Community Health and Evaluation (CCHE) did. They worked with a team from PHSKC to evaluate the initiative.

Teamwork for the win

Their assessment indicated that a whopping 22 of the 24 strategies achieved significant progress, and most (75 percent) of the grantees and subcontractors rated their experience as very good or excellent. The most common success factor was having two people dedicated to working together to bring about the change. Normally this consisted of a consultant or public health department staff working closely with a champion from the participating organizations. The researchers conclude that having an initiative structure that creates and supports this type of dyad is a promising approach.

Cheadle and Cromp published their findings with co-authors James W. Krieger, MD, MPH; Nadine Chan, PhD, MPH; Molly McNees, PhD; Sarah Ross-Viles, MPH; Ryan Kellogg, MA; Afsaneh Rahimian, PhD; and Erin MacDougall, PhD: Promoting Policy, Systems, and Environment Change to Prevent Chronic Disease: Lessons Learned From the King County Communities Putting Prevention to Work Initiative in the Journal of Public Health Management and Practice.

By Casey Luce, MSPH. Casey Luce is a project manager at Group Health Research Institute.