Organizations striving to support the health, wellness, and quality of life of their communities must understand their program results in order to improve. Evaluation can help organizations reduce uncertainties, improve the effectiveness of strategies, and make decisions about resource allocation (University of Texas, 1998). Strong measurement and improvement systems enable programs to show success and identify areas for growth. This attracts clients as well as funders and provides critical information to key stakeholders.

However, our systems in North Carolina are stretched thin, and many health and social service providers and promoters need assistance with evaluation, implementation and improvement. Often when consultants assist with evaluations, their support ends with project contracts, leaving an ongoing void. Further, evaluations and planning efforts too often fail to include the input of community members receiving or in need of services.

Through the Culture of Results Initiative, the North Carolina Center for Health and Wellness (NCCHW) works with local, regional and state partners to assess impact, strengthen coordination, and improve programs and systems statewide. NCCHW's Culture of Results is a training and technical assistance program that supports state initiatives, local public health departments, hospitals, clinics and community providers in measuring impact and improving results. Culture of Results applies key aspects of the empowerment evaluation model— providing evaluation as an iterative planning process to support self-determination and empowerment of clients and capacity building of organizations. Culture of Results team members engage partner organizations in learning and using a framework known as Results-based Accountability (RBA) and its evidence-based, common sense tools to plan and evaluate their projects and services. RBA has been recognized by the Center for Disease Control (CDC), the National Institute of Health (NIH) and other governmental agencies as an effective practice for evaluation and planning. Clients are participants who quickly develop the skills and capacity to evaluate their own services to adapt, improve and expand.

Culture of Results Initiative Impact

• Culture of Results provides training in exercises that can easily be used again and again to strengthen the capacity of programs, giving clients the ability to sustain their own efforts.
• Technical assistance helps clients co-create tailored evaluations to meet grant, government, or internal reporting requirements.
• Culture of Results workshops teach participants simple, clear language and processes that all stakeholders can understand and participate in, making planning more inclusive.
• Culture of Results applies Results-based Accountability (RBA), an evidence-based, action-oriented, and data-driven framework to improve population health and well being and program performance. RBA enables programs and organizations to focus on action, critical collaborations, and quality data for transparency and accountability of success, making it well suited to cross-sector collective impact work.
• Culture of Results is an initiative of the North Carolina Center for Health & Wellness at University of North Carolina Asheville. Culture of Results leverages the strength of the University’s community engagement efforts and academic programs, including in some cases faculty and student research.

CHALLENGES

According to the Association for Community Health Improvement, the health care system in our country is undergoing rapid and complex changes, that have critical impact on many Americans. While the Affordable Care Act has afforded unprecedented access to health care services, clinical care is not enough for communities to reach their highest potential for health. To achieve this lofty goal, exceptional collaboration is necessary — both within health care systems and throughout the community with multi-sectoral stakeholders. Hospitals throughout the United States are taking steps toward improving community health through their community health needs assessments and population health management practices. This is a time of great opportunity for community benefit and community health professionals to apply their knowledge and skills to transform our health care system into one that is adept at promoting the health of communities in the clinic and where people live, learn, work and play. The impact that we can have working together is far greater than that of each individually.

Many health and social service providers are working together to strengthen our systems across North Carolina. But demand continues to outweigh our capacity. Applying data-driven approaches to planning, taking action and evaluation and improvement are critical to support the health and well being of all North Carolinians.

Through technical assistance, program development, evaluation and leadership, the Culture of Results program will bolster health systems and service providing programs to help improve the health resources for at least one in ten North Carolina residents by 2018.

Map of Counties Impacted by Culture of Results Trainings (July 2018 Updated)

UNC Asheville - Community Engagement Council, The Key Center, and The Center for Diversity Education

WNC Health Network- WNC Healthy Impact and WNC Triple Aim Initiatives

Buncombe County Health and Human Services- Mobilizing Action for Resilient Communities and Community Health Improvement Plan Initiatives

MAHEC- Community Centered Health Homes Initiative/Mothering Asheville

Family Justice Center- HelpMate and OurVoice Community Service Project

YWCA of Asheville

Buncombe County ACE Collaborative & Painkiller Task Force

Community Food Strategies and Food Policy Councils across NC

With support from The Blue Cross Blue Shield Foundation of North Carolina