Evaluation Findings from 2002 - 2005 For the State and Local Healthy Maine Partnerships Initiative Patricia Hart

1. Evaluation Findings from 2002 - 2005 For the State and Local Healthy Maine Partnerships Initiative Patricia Hart Maine Center for Public Health Evaluation Team

2. Our Generous Evaluation Funding is From Several Sources • Fund for Healthy Maine- Maine’s Share of the Tobacco Settlement • CDC- Cooperative Agreements with the Maine Cardiovascular Health Program • CDC-Cooperative Agreements with the Maine Physical Activity and Nutrition Program Oversight is provided by the Senior Manager for the Healthy Maine Partnerships, Program Managers from PTM, MCVHP and PAN Programs A very big THANK YOU to Dorean Maines from PTM!

3. Introducing the New Evaluation Team for 2005/2006 Maine Center for Public Health- Prime Contractor Financial Management Brenda Joly, Amy Black- Lead Evaluators Hart Consulting- Project Manager, Lead Evaluator Market Decisions- Survey Research Harvard School of Public Health- Public Health Research and Evaluation Support Maine Health Information Center- Healthcare Data Analysis

4. Evaluation Background 2002- 2005 Team included the Gallup Organization, Hart Consulting, Market Decisions, UMaine Orono • Followed the CDC Evaluation Framework • Created 5-Year Evaluation Plans for PTM, MCVHP programs and the HMP initiative - approved December 03 • Established Performance Indicators for PTM, MCVHP, HMP • Set-up primary data collection • Evaluated individual program components- PTM, MCVHP

5. Evaluation Scope 2002- 2005 2 State-Level HMP Programs • Partnership For A Tobacco-Free Maine (PTM) • Maine Cardiovascular Health Program (MCVHP) Local HMP Initiative • Outcomes- Policy and Environmental Change Outcomes • Process Evaluation on the Partnership and Coaltion

6. Primary Data Collection Tools • Youth Tobacco Survey-- partnership with the Office of Substance Abuse-- paper based survey administered to youth to understand their knowledge, attitudes and practices on tobacco use -- currently in-process to field in Feb 2006 • Adult Tobacco Survey-- Random Digit Dial (RDD) telephone survey of adults (over 18) to understand their knowledge, attitudes and practices on tobacco use also included a module of questions on CVD.-- 4 year intervals • Environmental Indicators-- inventory of statewide local policies and environments that support program goals. Telephone surveys of all municipalities, all school administrative units and all non-institutional hospitals.

7. Evaluation of Local HMPs Local HMPs • Local HMP Outcome Surveys-- in 2003- telephone survey; 2005 paper booklet survey- to understand state resources use, policy or environmental change outputs and activities implemented by the local HMPs • Qualitative Evaluation of local HMPs- 2003- focus groups with Partnership Directors and School Health Coordinators to understand coalition building - opportunities and challenges • Lead Agency Key Informant Interviews-2004- in-depth interviews with lead agency directors and superintendents to understand experience with the state and local HMP

8. Individual Program Component Evaluations Completed- 2004/2005 • MCVHP Worksite Pilot Project Evaluation- 3 studies- Heart Check, Wellness Coordinator Interviews, Employee Surveys • Youth Advocacy Coordinator Key Informant Interviews • LifeSkills Implementation Evaluation- (low response rate) • Tobacco Treatment Training - Follow-up Survey Some earlier studies had low participation rates and therefore provide qualitative insights- Physical Activity Action Kits, No Buts!, Tobacco Free Athletes, CATCH

9. Findings Show Local HMP Initiative is Working! • Successful raising additional funding- $2.8 million in 2004 • Established high functioning coalitions • Working toward outcomes of policy and environmental change to reduce tobacco use, increase physical activity and improve nutrition • School/Community partnership is working • Reaching out to other organizations in the community • Creating, nurturing and maintaining coalitions takes time and commitment

10. Challenges to Success • Uncertain funding- hard to keep people committed • Unclear goals, expectations in the beginning • Mixed messages from state • Schools struggle with competing priorities • Time is precious!

11. The Local HMP Outcomes Contribute to Overall State Progress Program Components Environmental Indicators Population Surveys Health Statistics • Local HMP Coalitions • Awareness • Outreach • Policy/Env Change Increased State and Local Policy and Environmental Changes Decreased Morbidity Decreased Mortality Improved Quality of Life Sustained Improved Health Behaviors • State Programs • Counter-marketing • Programming • Surveillance/Evaluation Change in Knowledge Attitude and Behaviors Population Surveys • Partners/Key Supports • Funding • Programs • Stakeholder input and support • State Policies/Laws Improvements in Health Status Outputs/Activities Change Statewide Change Sustained Behavior Change

12. Tobacco Control Promotion in Maine Partnership For A Tobacco-Free Maine Local Healthy Maine Partnerships State and Local Partners

13. Local HMP Youth Tobacco Use Prevention • LifeSkills Training– substance abuse resistance training • Tobacco Free Athletes– role-modeling for positive choices • Tobacco-Free School Policy– exceeds state laws on tobacco prohibitions for schools • No Buts!– training on retail access restrictions • Youth Advocacy Program • Policy and Environmental Changes to support no tobacco use and increased access to quit options

20. See Environmental Indicator Maps for Statewide Local Policy Change to Address Tobacco Use

25. Local HMP Work with Adults on Tobacco Issues • Maine Tobacco HelpLine • Tobacco Treatment Training • Group Counseling Sessions on Tobacco Cessation

29. Trends in Smoking Prevalence/BRFSS

32. Challenges Remain in Reducing Tobacco Use • Too many high school students smoke- 1 out of 5 • Young adults, 18 – 24 have the highest smoking rates • People with lower income have higher prevalence of smoking • Many want to quit- 75% and many have tried quitting in past year- 60%

33. Physical Activity Promotion in Maine Maine Cardiovascular Health Program (early years) Maine Physical Activity and Nutrition Program Local Healthy Maine Partnerships State and Local Partners

38. Environmental Indicators for Physical Activity ..\Physical Activity Maps.ppt

45. Long Road Ahead to Increase Physical Activity • Local HMPs have made great progress in implementing policy and environmental changes to support increased physical activity in their communities and schools • Most adults- 3 out of 4 recall advertising messages related to healthy choices- physical activity, nutrition • Only 1 out of 4 reports engaging in regular- moderate physical activity

46. Improving Nutrition in Maine Maine Cardiovascular Health Program (early years) Maine Physical Activity and Nutrition Program Local Healthy Maine Partnerships State and Local Partners

49. Environmental Indicators for Nutrition ..\nutrition maps.ppt