What Gets Measured Gets Done: Using Performance Measures to Promote and Monitor the Adoption of Evidence-Based Practices in a Federal Public Health Program

Introduction:  This presentation outlines the process of developing and implementing performance measures that are linked to best practices for the Centers for Disease Control and Prevention’s (CDC) Preventive Health and Health Services Block Grant (Block Grant) Program.  Established in 1981, the Block Grant Program provides flexible funding to states, territories, and tribes to respond to critical local public health issues that cause illness, disability, and death.  Block Grant Program performance measures were developed to enhance accountability, guide program improvement, and to encourage and evaluate the implementation of evidence-based environmental change strategies.

 Methods:  We conducted an environmental scan of best and evidence-based  practices by Block Grant Program focus areas, which include changing the built environment to increase physical activity and changing the food environment to decrease obesity.   We engaged key stakeholders to develop and refine performances measures that were aligned with recommended public health strategies, and we pilot-tested measures with grantees of varied characteristics.     

 Results:  Pilot data and feedback collected from grantees and federal staff by web survey and in-person debriefings suggests that the Block Grant Program performance measures will help to focus grantees’ efforts on priority public health strategies that are aligned with best and evidence-based practices.  For example, grantees felt that Block Grant performance measures related to the Built Environment are easily identified with evidence-based strategies for altering the physical environment to promote physical activity and reduce obesity (e.g., improve access to outdoor recreational facilities).  Moreover, the open-text format of performance measure reporting templates, in addition to the more quantitative fields, allows program managers to gather useful data on implementation challenges and facilitators that may help inform technical assistance tools and resources.

Conclusion:   Engaging key stakeholders to establish performance measures that are aligned with program focus areas and evidence-based practices can encourage grantees to implement evidence-based public health strategies and effective interventions.  Importantly, performance measurement systems can include the collection of data on factors that facilitate and challenge grantees’ efforts to implement evidence-based practices.  This useful contextual data can guide refinements to performance measures and reporting systems, but also be used to inform the development of training and technical assistance tools to better support the translation of evidence-based interventions.

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