The Healthy Community Coalition

Curriculum Development: The design, format, and content development of the 8-week GOAL curriculum was extremely time consuming. Inefficiencies due to time constraints and resource availability between the initiative and the contracted marketing firm contributed to significant delays in completion of the GOAL facilitator and participant guide.

Possible Solution: Every attempt should be made to identify an existing evidence based curriculum, which reinforces small incremental changes to better health. The curriculum must be flexible to adapt to the limited resources of a rural environment, and promote social support. In addition any materials should be thoroughly reviewed to ensure they meet evidence-based plain language standards.

GOAL group logistics and facilitation: GOAL group facilitation and coordination was a challenge. Most associations and organizations are receptive to holding a group, but finding facilitators continued to be problematic and limited the number of people reached with this program.

Possible solution: Encourage GOAL group graduates to become GOAL group leaders. Once individuals complete the 8-week program their self-confidence, success in creating and reaching goals, and knowledge of the material make them ideal group leaders. This also helps sustain the program by eliminating the need for training sessions lead by HCC staff.

Provider engagement: Integration of this initiative in physician offices suffered due to varying levels of expertise among the medical community in addressing obesity and overweight issues with patients. Some physicians remain clearly uncomfortable broaching the subject with their patients.

Possible solution: Due to the significant delay in implementing provider-referred GOAL groups, this problem will be addressed during the no-cost extension period, through the establishment of standard scripted protocols.

Process Evaluation: Data collection efforts through participant and facilitator satisfaction surveys and group tracking forms are designed to monitor activity implementation. Archival data such as minutes, agenda, and attendance sheets are maintained. Following completion of a GOAL group, a follow-up brief telephone or in-person interviews is conducted by program staff & group leaders to explore and further any process modifications i.e. barriers.

Outcome Evaluation: The implementation of GOAL groups countywide is growing after a slow start up period. The outcome evaluation is assessed through the use of a participant health survey administered pre & post, which includes a 12 item quality of life, KABS & readiness measures, and a self-report ScoreHealth screenings which measures health status, BMI, blood pressure, physical activity, tobacco use, nutrition & stress. A final report will be provided at the end of the no-cost extension.

HCC has begun to weave components of this initiative into the Healthy Maine Partnership program whose goals and evaluation strategies closely align with those implemented over the past three years. In addition, funding awarded from the Office of Women’s Health has defined the GOAL program as an effective strategy to further promote and impact work-site wellness. Perhaps, the most significant sustainability measure is HCC long-term commitment to healthy lifestyle initiatives, with ongoing funding from State tobacco settlement funds, a diverse range of private foundations, and an endowment from Franklin Community Health Network.

HCC will continue to include new information on obesity and overweight into its existing activities, such as, five school districts, physician offices, health centers, community settings, and on its mobile health outreach program funded by the United Way.