Policies may inadvertently create disparities during their implementation that may not be fully realized until an evaluation is conducted. The Center for Evaluation Innovation (CEI) and Virginia Concussion Initiative (VCI) will share their approaches, challenges, and anecdotes from two different health policy implementation evaluations. Despite the similarity in methods, each group faced different obstacles with tool development, demographic clustering, data availability, coordination with other evaluation consultants, stakeholder engagement, data collection, and the shifting political climate. These challenges have resulted in different strategies to ensure evaluators are asking the right questions and advocating for underserved groups to promote policy and systems change. Attendees will learn about existing contributions to the field of policy implementation evaluation and strategies that may be instrumental to inform future practice.
The Virginia Concussion Initiative was commissioned by the Virginia Department of Health (VDH) via the CDC to evaluate implementation of a Virginia Department of Education (VDOE) policy. The cross-agency interest derived from the health nature and educational setting of the policy. This unfunded mandate requires increases in infrastructure, resources, and processes but does not provide schools divisions with the means to build internal and community capacity. As a result, some school divisions are marginalized in their ability to meet the legislative standard. Implementation in Virginia has never been studied since the bill was enacted in 2010. Shifting best practices led to two amendments in 2014 and 2016, but a model policy template only aligned to the 2010 bill and was never revised to keep pace with the changing landscape. The aim of this study is to develop recommendations that are responsive to unique cultural barriers that impede local policy implementation.
The California Endowment's (TCE) Building Health Community Initiative (BHC) is a $1 billion comprehensive community initiative to achieve healthy, fair, and just communities for all people who call California home by investing in the social, economic, and political power of residents who have been the targets of exclusion, stigma, and discrimination. TCE aims to use policy, systems, and narrative change by building the power of 14 California communities to tackle health inequities. Over the course of 9 years, more than 700 policy "wins" have been achieved through BHC. The Center for Evaluation Innovation's (CEI) evaluation is focused on what happened after these “wins”—the extent to which resident-led advocacy and related “wins” expands power in communities and contributes to ongoing advocacy during implementation.