The Health Action Fund: A Community-Based Approach to Enhancing Health

Abstract

T his article is based on a program that was developed by the Center for Healthy Communities (CHC), a communityÈacademic partnership in Dayton, Ohio, that continues to act as a force for change in health professionsÏ education and health delivery, stressing the philosophy of ""doing withÏÏ instead of ""doing forÏÏ or ""doing to.ÏÏ T he Health Action Fund is a grassroots health communications and social marketing program that targets community groups who are involved often in health promotion activities developed by large agencies. However, rather than taking the traditional approach to health promotion and prevention where program development and implementation is left to professionals, a di †erent approac h was taken that encourages members of neighborhood s, a community group, or a church to identify a problem and then develop a way to address that problem for their group. T he program focuses on neighbors helping neighbors where communities take the lead in health promotion and prevention activities.W e discuss in detail the projectÏs innovation, challenges and how they have been addressed, qualitative and quantitative improvements made to the program, and how the program serves as a model for other communities.

Evaluation Methods in Community Microgrant Programs for Health Promotion: A Scoping Review

“…All 18 full-text sources that met the inclusion criteria were academic publications published between 1996 and 2020. Of the 14 microgrant programs described, 9 were based in the United States,20–23,26–33 2 in Australia,34,35 and 1 each in Canada,24,25 the Netherlands,36 and the United Kingdom 37. Five programs were based in urban areas,27,30,31,33,36 2 in rural areas,28,34 and 7 covered a diverse range of communities 20–26,29,32,35,37.…”

“…Target populations included youth/adolescents,24,25,29 women,35 and Black and Latino populations 31. Most programs were operational for 3 years or less,20–23,26,28,29,31–33,35 though 1 ran for 10 years24,25 and 3 were ongoing at the time of publication27,30,34 (2 sources did not discuss the continuation of programming) 36,37. Program funding mainly originated from government agencies20–23,28,31,33–37; philanthropies26,30; partnerships between academic institutions, philanthropies, and communities27,29,32; or in one case, a large private corporation 24,25.…”

“…Most programs were operational for 3 years or less,20–23,26,28,29,31–33,35 though 1 ran for 10 years24,25 and 3 were ongoing at the time of publication27,30,34 (2 sources did not discuss the continuation of programming) 36,37. Program funding mainly originated from government agencies20–23,28,31,33–37; philanthropies26,30; partnerships between academic institutions, philanthropies, and communities27,29,32; or in one case, a large private corporation 24,25. The broad aims of the publications were to report on microgrant program implementation20–22,24,26,28–30,32–36; report on microgrant program outcomes20,23,24,28,31,36,37; discuss facilitators/barriers/challenges related to the microgrant program21,27,30,34,35; and discuss lessons learned and implications for practice, policy, and program replication 20–22,27,28,30,33,35…”

“…A summary of findings mapping the evaluation methods of included sources can be found in Table 3. All of the evaluation teams comprised at least 1 academic, with evaluators of other backgrounds coming from health services,26,28,32 government agencies,20–23,30,37 a specialist evaluation group or consultancy,20–23,26,27 philanthropies or other nonprofits,29–31 and the community 32. Financial support for the evaluations was made explicit in 9 of the 14 microgrant programs, with funds being provided by government agencies,20–25,31,32,34,35,37 philanthropies,24,25,33,36 an academic institution,20–23 and a large private corporation 24,25.…”

“…Of the 18 published evaluations, only 1 utilized a formal evaluation framework, notably the social-ecological framework operationalized through Social Return on Investment methodology 37. Eleven publications described an ad hoc framework20–23,25,29,31–34,36 and 6 did not discuss an evaluation framework 24,26–28,30,35. As an example of an ad hoc framework, Smallwood et al33 established 3 program domains to be evaluated ( establishing community presence, building trust and connections , and building community capacity ), defining these operationally and categorizing program activities within each of these domains.…”