Phase 6: St. Louis County, MO Vignette
The Action Cycle
The St. Louis County Department of Health (SLCDOH) serves a large urban and suburban geographic area surrounding the city of St. Louis. The county consists of 524 square miles of land, approximately one million persons, 92 municipalities, and 24 school districts. In 1997, SLCDOH embarked on the "In-Partnership" process to assist in more accurately and effectively assessing and serving the communities in the area. A collaborative community health planning process with the Jennings community and an internal core functions based training process, which included ongoing collaborative activities with distinct communities in the county, were implemented. To support and improve both of these coordinated efforts, SLCDOH integrated an evaluation plan into the process to measure core functions implementation.
To evaluate the success of the initiative and the achievement of the project's goals, an Advisory and Evaluation Team was created. The Advisory and Evaluation Team was comprised of one Grant Oversight Committee member (this committee was formed to oversee the entire project), local experts, and representatives from the St. Louis University School of Public Health, Washington University, the University of Missouri-St. Louis, the SLCDOH Advisory Board, and the University of Missouri Columbia School of Nursing. Members of the Advisory and Evaluation Team assisted in the design of the In-Partnership model from the outset; therefore, they were familiar with and involved in the process from the beginning.
The Advisory and Evaluation Team assisted SLCDOH staff team in the development of program outcomes that will evaluate the effectiveness of the pilot In-Partnership Project. The Advisory and Evaluation Team was also formed to make recommendations that will enhance the success of the pilot program and can be used to replicate the pilot program in other communities.
Representatives from the St. Louis University School of Public Health assisted the Grant Oversight Committee in designing surveys to evaluate the community coalition's effectiveness and to evaluate DOH staff activities and attitudes related to community-oriented core public health functions. Additionally, through a concurrent metropolitan-wide initiative sponsored by a collaboration of regional interests, SLCDOH has been linked to the HealthCare Forum's Accelerating Community Transformation project. Through this project, it will be participating in an effort to share results and measure outcomes at the community level.
St. Louis County's experiences present a good model for integrating evaluation from the initiation of the project design. St. Louis County accomplished this by forming a broad-based evaluation team, including the team in the design of the process, and focusing on identifying outcomes while the process was under way. By doing this, St Louis County will be able to obtain valuable data through its evaluation, which can ultimately be used to improve community health outcomes.