Evaluation of Community-wide Health Promotion Interventions

• Author / Creator

  Yun, Lira

• The purpose of this thesis was to expand the evaluation of community-wide health promotion interventions aimed at individuals by first reviewing previous evaluation research of the effectiveness of community-wide interventions and then incorporating new approaches in implementation and outcome evaluation. To achieve this goal, the first study of the thesis was a systematic review of recent evaluation research that illustrated the effectiveness of community-wide media physical activity campaigns. Twenty-three articles (18 campaigns) were included from the initial 1,692 articles found in 13 databases. The review found that the evaluation of community-wide media physical activity campaigns varied in their respective scope, duration and target population. The effectiveness of the campaigns was determined by individual changes either in proximal, intermediate, or distal level outcomes. The review data supported previous research that the effect size of the campaign decreased when the level of the outcomes moved from proximal to distal. The role of automatic and implicit cognitions in campaign evaluation research has yet to be identified; rather, most research has incorporated explicit and controlled cognitions that are measured using self-report questionnaires. The outcomes of the first study provide guidance for health promoters to implement successful interventions and best practice.
  The second study of this thesis tested the effects of a community-wide physical activity campaign (UWALK) by examining the relationships among proximal, intermediate, and distal outcomes as outlined in the hierarchy of effects model. Furthermore, the study incorporated the measure of automatic processes (attentional bias and implicit attitudes) in addition to controlled processes (self-reported awareness and explicit attitudes). Participants (N = 127) reported unprompted awareness and then completed online implicit tasks. Next, they rated prompted awareness of UWALK before watching a UWALK video, and finished questionnaires measuring instrumental and affective attitudes, and leisure time physical activity. Results showed that participants with unprompted awareness of UWALK demonstrated attentional bias toward UWALK images, positive implicit attitudes, and greater leisure-time physical activity compared to unaware counterparts. Attentional bias, awareness, and implicit attitudes significantly predicted behavior, accounting for 15.2% of the variance. However, explicit attitudes were neither related to awareness nor to physical activity. This study demonstrated the importance and feasibility of measuring automatic cognitions in campaign evaluation and provides additional information independent of self-reported controlled cognitions.
  The third study was to assess a collaborative partnership between a public and private organization when implementing a smoking cessation program (Run to Quit) based on participants’ perspectives. A qualitative description method and inductive analysis process guided the study in order to comprehensively summarize participants’ experiences of the Run to Quit program. A total of 14 informants participated in a semi structured phone interview two months after the program ceased. The results provided potential benefits of public-private partnerships collaborating in the program delivery as well as the challenges in managing the program when multiple organizations are engaged. It is further proposed that who a public organization partners with will possibly affect how individuals evaluate information of the intervention; examining automatic cognitions such as attentional bias and implicit attitudes triggered by partner names or logos in the intervention advertisements is proposed to be included in the campaign evaluation framework.
  Behavior change interventions are fundamental to the effective practice of public health. The evaluation of interventions that have been conducted in real world settings serves guidance for health promoters when they establish an evidence-based intervention. PPPs in implementation of community-wide health promotion interventions continue to engage the attention of public sector in search of strategies to mobilize resources beyond those available to public sector entities alone, and offering solutions to complex problems. Examining the consequences of PPPs on the implementation and outcome of the intervention provide evidence whether the partnership has actually resulted in positive impacts on participants.

• Subjects / Keywords

  • evaluation
  • public-private-partnership
  • community-wide
  • dual-processing
  • interventions

• Graduation date

  Fall 2018

• Type of Item

  Thesis

• Degree

  Doctor of Philosophy

• DOI

  https://doi.org/10.7939/R3V40KF77

• License

  Permission is hereby granted to the University of Alberta Libraries to reproduce single copies of this thesis and to lend or sell such copies for private, scholarly or scientific research purposes only. Where the thesis is converted to, or otherwise made available in digital form, the University of Alberta will advise potential users of the thesis of these terms. The author reserves all other publication and other rights in association with the copyright in the thesis and, except as herein before provided, neither the thesis nor any substantial portion thereof may be printed or otherwise reproduced in any material form whatsoever without the author's prior written permission.