title: Evaluating Policy, Systems, and Environmental Change Interventions: Lessons Learned From CDC's Prevention Research Centers.
abstract: BACKGROUND
  The field of public health is increasingly implementing initiatives intended to make policies, systems, and environments (PSEs) more supportive of healthy behaviors, even though the evidence for many of these strategies is only emerging. Our objective was 3-fold: 1) to describe evaluations of PSE-change programs in which the evaluators followed the steps of the Centers for Disease Control and Prevention's (CDC's) Framework for Program Evaluation in Public Health, 2) to share the resulting lessons learned, and 3) to assist future evaluators of PSE-change programs with their evaluation design decisions.
  
  
  METHODS
  Seven Prevention Research Centers (PRCs) applied CDC's framework to evaluate their own PSE-change initiatives. The PRCs followed each step of the framework: 1) engage stakeholders, 2) describe program, 3) focus evaluation design, 4) gather credible evidence, 5) justify conclusions, and 6) ensure use and share lessons learned.
  
  
  RESULTS
  Evaluation stakeholders represented a range of sectors, including public health departments, partner organizations, and community members. Public health departments were the primary stakeholders for 4 of the 7 evaluations. Four PRCs used logic models to describe the initiatives being evaluated. Their evaluations typically included both process and outcome questions and used mixed methods. Evaluation findings most commonly focused on contextual factors influencing change (process) and the adoption or implementation of PSE-change strategies (outcome). Evaluators shared lessons learned through various channels to reach local stakeholders and broader public health audiences.
  
  
  CONCLUSIONS
  Framework for Program Evaluation in Public Health is applicable to evaluations of PSE-change initiatives. Using this framework to guide such evaluations builds practice-based evidence for strategies that are increasingly being used to promote healthful behaviors.
authors.affiliation: Emory Prevention Research Center, Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, 1518 Clifton Rd NE, Atlanta, GA 30322. Email: shoneyc@emory.edu.
authors.forename: Sally
authors.initials: S
authors.lastname: Honeycutt
authors.affiliation: School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, North Carolin.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Leeman
authors.affiliation: Fielding School of Public Health and Jonsson Comprehensive Cancer Center, University of California Los Angeles, Los Angeles, California.
authors.forename: William J
authors.initials: WJ
authors.lastname: McCarthy
authors.affiliation: Fielding School of Public Health and Jonsson Comprehensive Cancer Center, University of California Los Angeles, Los Angeles, California.
authors.forename: Roshan
authors.initials: R
authors.lastname: Bastani
authors.affiliation: Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
authors.forename: Lori
authors.initials: L
authors.lastname: Carter-Edwards
authors.affiliation: Texas A&M School of Public Health, College Station, Texas.
authors.forename: Heather
authors.initials: H
authors.lastname: Clark
authors.affiliation: Texas A&M School of Public Health, College Station, Texas.
authors.forename: Whitney
authors.initials: W
authors.lastname: Garney
authors.affiliation: Tulane University School of Public Health and Tropical Medicine, Prevention Research Center, New Orleans, Louisiana.
authors.forename: Jeanette
authors.initials: J
authors.lastname: Gustat
authors.affiliation: University of Alabama at Birmingham Prevention Research Center, University of Alabama at Birmingham, Birmingham, Alabama.
authors.forename: Lisle
authors.initials: L
authors.lastname: Hites
authors.affiliation: University of Iowa Prevention Research Center for Rural Health, College of Public Health, University of Iowa, Iowa City, Iowa.
authors.forename: Faryle
authors.initials: F
authors.lastname: Nothwehr
authors.affiliation: Emory Prevention Research Center, Rollins School of Public Health, Emory University, Atlanta, Georgia.
authors.forename: Michelle
authors.initials: M
authors.lastname: Kegler
mesh_terms: D002487:Centers for Disease Control and Prevention, U.S.; D003159:Community-Institutional Relations; D004781:Environmental Exposure; D005069:Evaluation Studies as Topic; D017144:Focus Groups; D006291:Health Policy; D006293:Health Promotion; D006801:Humans; D033181:Information Dissemination; D009936:Organizational Innovation; D016134:Organizational Policy; D011314:Preventive Health Services / Q000458:organization & administration; D015397:Program Evaluation / Q000379:methods*; D015980:Public Health Practice / Q000592:standards*; D013597:Systems Analysis; D014481:United States