Diabetes

Evaluation of Environment & Policy

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You can visit Evaluation on the navigation bar below for general information on evaluation. This section is designed to add to this general information by giving you special considerations for evaluating diabetes environment and policy initiatives.

Work with members of the community of interest to identify community needs and gain support from local government officials, policy-makers, community members, and other community decision-makers through participatory approaches or focus groups. Diabetes environment and policy initiatives might include an assessment of current diabetes-related policies or environments in order to examine what changes need to be made or what new policies or developments need to occur to meet the needs of the community. You can also assess health risks of diabetes and the benefits of diabetes-related prevention and management behaviors (e.g., glucose monitoring, taking medications, eating balanced nutritious meals, getting physical activity, quitting tobacco use). Others have also included an assessment of the existing access to resources (e.g., medical supplies, nutritious foods, aerobics classes) and places (e.g., pharmacies, supermarkets, community gardens, parks, playgrounds, gyms) to support diabetes prevention and management. To develop an effective policy or environment initiative, the specific historical, cultural, and political contexts as well as the economic impacts of diabetes-related changes are important to understand and evaluate.

Once changes have been made to environments or policies, you can evaluate the community awareness of the changes, perceptions of the changes, and enforcement of the changes in the environment or policy. Community- wide surveys could be used to measure these factors and to assess changes diabetes-related behavior patterns and health outcomes. Alternately, it is possible to track the use of facilities (e.g., walking trail counters) or changes in food purchasing patterns (sales data) when special tools are used or existing data is collected and summarized. 

There are several challenges in evaluating diabetes environment and policy initiatives that should be considered:

  • It is very challenging to establish causality (e.g., changes in the cost of diabetes medications led to increased self-management behaviors). Some individuals may have changed their self-management behaviors because of pressure from family and friends, and some may have changed their behavior on their own. It is important to get as much information as possible about the reasons for behavior changes.
  • The exact combination of diabetes intervention strategies (environmental changes, policies, individually adapted strategies, etc) that will be best to change rates of diabetes and related health complications is unknown. 
  • When diabetes environment and policy initiatives are used, it is difficult to figure out which intervention strategies led to the changes that were observed in the evaluation.

Sharing Your Work

The following questions haven been provided to help guide the discussion you have with your partners about sharing your work with others:

  • What is the goal of sharing our work? What action do we want others to take?
  • Which group needs to take action right now? Which group is the primary audience at this moment?
  • What does this audience care about? What values do we share with this audience?
  • What is our message to this audience? What do they need to hear to take action?
  • What media outlets does our audience follow? Which newspapers do they read? Which radio stations do they listen to? Which television newscasts do they watch?
  • Who are our opponents?
  • What is their message to our audience?

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