Evaluation center focuses on improving rather than proving

GHRI’s Center for Community Health and Evaluation welcomes its new director, Allen Cheadle, PhD, and thanks founding director Bill Beery, MPH. Dr. Cheadle's plans include increasing collaborations with the Institute’s scientific researchers.

“It’s hard to standardize and randomize communities,” says Allen Cheadle, PhD, new director of the Center for Community Health and Evaluation (CCHE) at Group Health Research Institute (GHRI). A randomized clinical trial is the gold standard for testing the value of a treatment, but how do you tell if a community health program is working?

That's the job of CCHE’s multidisciplinary team of evaluators. They assess a wide array of community-based health improvement programs such as initiatives to encourage healthy eating and active living, and health care policy changes aimed at improving community health.

“We are involved across the spectrum of a project,” say Clarissa Hsu, PhD, a senior member of the CCHE team. CCHE’s hands-on approach involves work during the assessment and planning phases of projects to help programs clearly articulate their desired outcomes.

Unlike more traditional health research, says Dr. Hsu, “feedback and improvement are our goals. We don’t have concerns about biasing programs by giving them continuous information about what’s working.”

Bill Beery, MPH, founding director of CCHE, calls this “improving instead of proving.”

CCHE is funded almost exclusively by private health-related philanthropies and nonprofit organizations. An example CCHE project is evaluation of the Kaiser Permanente Community Health Initiative, created in 2003 to promote obesity-prevention programs. Beery explains that community benefit programs like these fulfill a tax requirement for nonprofit health systems such as Kaiser Permanente and Group Health, and are increasingly seen as an opportunity to reduce costs by creating a healthier client population. CCHE’s participation in all stages of this program gives its investigators and staff experience to apply in other settings, such as developing community benefit strategies for Group Health. CCHE’s work also connects Group Health to organizations across the country that are interested in improving public health—especially in vulnerable communities.

CCHE’s collaboration with Dr. Cheadle began fifteen years ago when he was a professor in the Department of Health Services at the University of Washington School of Public Health. He has played a key role in CCHE ever since, including the evaluation of the Kaiser Permanente Community Health Initiatives, which he has led for seven years. Dr. Cheadle earned a doctorate in economics from the University of California, Berkeley in 1987, but says, “By the time I got my degree, academic economics was largely another branch of mathematics. My motivation for doing economics was to influence policy,” so he applied his training to community health instead.

Dr. Cheadle's close work with CCHE made him an excellent choice to become its new director in April 2011. “I don’t envision big changes right away,” he says, “I’ll spend some time getting to know CCHE and how we fit into GHRI and Group Health before making any major changes.” Dr. Cheadle has a definite long-term vision, though: to integrate CCHE more fully into GHRI, including doing more collaborative projects with GHRI scientific investigators.

More extensive integration into GHRI is a natural next step for CCHE, which started as the evaluation team for community health activities when Beery was head of the Center for Health Promotion and Department of Disease Prevention and Community Service for Group Health, from 1985 to 1997. The evaluation team explored opportunities to work for foundations with health interests, and in 1997, Beery took this external work to the Group Health Foundation, where he was Vice President for Programs from 1997 to 2007. In 2007, Beery and the evaluation group, now called CCHE, moved to GHRI. CCHE currently has about 15 employees at GHRI and works closely with local evaluators across the country. CCHE typically runs 40 to 50 concurrent projects in up to 14 states.

Beery has guided CCHE since the beginning, so the leadership change is a landmark. “Bill really cares about people—those who work for and with him and those in the organizations that CCHE works with,” says Dr. Cheadle. “That care and concern underlies everything he does, and has made him a great boss and leader. I can’t be Bill but think I have some of that same motivation for doing the work.”

By Chris Tachibana