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Evaluation
Research
The Alcohol & Public Health Research Unit was contracted by the Health Funding Authority (HFA) to undertake a two year formative evaluation of a regional pilot programme on sexual health for the Pacific Islands community in South Auckland. This work commenced in April 1997 with the development of an evaluation plan for the FLEP (Family Life Education, Pasefika) programme. The evaluation assists the programme providers to: develop this new sexual health service; monitor service delivery; and make continuous programme improvements. A series of recommendations were made in April 1998, all of which have since been adopted by the provider. Evaluation activities are progressing well in year two, with the HFA allocating additional funds to support a specific provider development initiative. Researchers: Lina Samu, Filo Talagi, Liz Stewart, Carla Spinola In 1995 the Alcohol & Public Health Research Unit undertook an evaluation of a promotion to encourage Pacific Island parents to use child restraint equipment when driving. The child restrain promotion was run by the West Auckland Pacific Island Health Fono and funded by North Health. The evaluation had two main aims: firstly, to assess the effectiveness of the promotion, and secondly, to assist in the development of a health promotion model for the Pacific Islands community resident in New Zealand. The methods employed included key informant interviews with stakeholders and documentation of the processes that they employed to conduct health promotion within their communities. Materials developed for the promotion were pre-tested with a sample of people from the six different Pacific Islands ethnic groups being targeted. Data was also collected on utilisation of the child restraint rental scheme. Interviews with the promotion's target population, Pacific Islands parents and care-givers, using semi-structured questionnaires, assessed the impact of the programme's various strategies. The evaluation helped to identify a number of issues relevant to the successful development and implementation of a health promotion project for Pacific Islands communities. Recommendations were developed which the programme could apply to enhance their work, but which will also inform future programmes. Researchers: Nite Fuamatu, Carla Spinola, Helen Schmidt From 1989-92 the Alcohol & Public Health Research Unit conducted formative, process and outcome evaluation for the Heartbeat New Zealand programme, funded by the Department of Health and administered by the National Heart Foundation of New Zealand. This programme which was designed to apply a population approach to the risk factors associated with cardiovascular disease. The overall aim of Heartbeat Awards was to promote healthy eating in a healthy environment by encouraging school canteens and workplace cafeterias to provide healthy food choices, hygienically prepared, in a smokefree environment. School Boards of Trustees were encouraged to include food policy in the school charter. Managers were encouraged to provide and promote a range of foods which were lower in fat, sugar and salt and rich in fibre and carbohydrates (eg. fruit, vegetables and wholegrain bread). The three factors of availability, price and promotion of food choices were central to the Heartbeat Awards approach. In 1989 the Alcohol & Public Health Research Unit provided formative evaluation for the pilot phase of Heartbeat Awards in schools, showing that Heartbeat Awards project model was workable, was viewed positively by participants and was likely to be effective in the longer term. Involvement in the pilot phase ensured that evaluation was built into the project design and timetable and helped establish the credibility of the project in the eyes of Heartbeat administrators and funders. The evaluation team assisted in the development of the management structure and practice; conducted interviews with programme personnel, reviewed research literature; obtained information from pilot project participants and increased the influence of programme staff in decision-making. A major role of the team was in collecting and feeding back information relevant to programme planning to encourage information-based decision-making, and providing consultation to planners and decision makers to help improve programme functioning. The outcome evaluation involved interviews with food manufacturers with whom coordinators had liaised to encourage products in line with the nutritional requirements of Heartbeat programme. Several manufacturers had taken steps to ensure beneficial pricing and adequate distribution of products to schools. Questionnaires and interviews asked managers of school food services about the effect of the project on food sales and profits. Most schools reported an increase in the provision and sales of healthier foods and a decrease in provision and sales of high fat, salt and sugar items. Another focus of the Heartbeat programme was workplace cafeterias. Outcome evaluation included telephone interviews with cafeteria and workplace managers in 30 workplaces randomly selected from the participating workplaces. Half said sales of high fibre, low fat and low sugar items had increased, as had sales of low fat milk since the project had begun. Seventy percent of cafeterias had made changes in the way they promoted 'heart-healthy foods. The project was also considered to have reinforced legislation on smoke free environments. The outcome evaluations raised important questions about how to best judge programme performance, and the in-depth knowledge of the programme that the evaluation team obtained assisted in the development of a appropriate evaluation framework. The comprehensive approach to evaluation of this multi-faceted programme provides a model which can be applied in a range of other health promotion and disease prevention situations. Researchers Evaluation of Cot Death Information In 1993 the Alcohol & Public Health Research Unit was commissioned by the Public Health Commission to undertake an evaluation of five pamphlets produced by the Cot Death Association. The primary aim was to assess the usefulness and quality of the material in increasing knowledge and awareness of the risk factors associated with Sudden Infant Death Syndrome. A series of key informant interviews and focus group discussions were held with Maori, Pakeha and Samoan parents and caregivers. A secondary aim was to determine the most appropriate channels for communicating information and education about the prevention of cot death. A literature review was undertaken to provide background to current research on the communication of health promotion information. The study found mixed reaction to the pamphlets, particularly to one of the four risk factors listed: bed-sharing. It concluded that pamphlets could play a role if used to complement other forms of communicating information about cot death, when developed for a specific audience, and if distributed appropriately. Researchers
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