Healthy Weigh (El camino saludable) Phase 1: A Retrospective Critical Examination of Program Evaluation

BACKGROUND: Healthy Weigh (El camino saludable) is an obesity prevention program for low-income, predominantly Hispanic and African American families in an urban community in Tarrant County, Texas. Healthy Weigh Phase 1 was a successful community–campus partnership that took place in summer (June–August) and fall (September–November) 2003. The program met stated objectives and extensively engaged students from several health disciplines in service learning. This article describes what we learned about the evaluation of the program by examining the phase 1 evaluation process. CONTEXT: Family environments are important intervention settings for establishing life-long dietary practices. Available in English and Spanish, Healthy Weigh Phase 1 helped families that were at risk for overweight and obesity to adopt healthy eating, physical activity, and weight management patterns. METHODS: Analysis of a program logic model and formative evaluation data identified evaluation questions that could have improved the phase 1 evaluation process. Questions were categorized according to Donabedian's structure–process–outcome framework, and potential benefits of each question were identified. The Centers for Disease Control and Prevention's Framework for Program Evaluation in Public Health standards were used to judge the overall quality of the phase 1 evaluation process. CONSEQUENCES: The phase 1 evaluation process successfully assessed the program's effects and generally met evaluation standards. Our critical examination also highlighted structure and process evaluation issues with potential for strengthening future interventions, community partnerships, and program outcomes. INTERPRETATION: Lessons learned influenced the phase 2 grant activities. Most importantly, we learned that involvement of program participants as full partners in program design, evaluation, and implementation is essential. Our understanding and practice of program evaluation evolved as Healthy Weigh became a true community-based participatory research endeavor.