Evaluation Considerations for Early Childhood Health Promotion Programs

There are several considerations that may be important when evaluating early childhood health promotion programs in rural communities.

Measuring impact with a small sample size. In rural communities, one of the greatest challenges to planning, implementing, and evaluating initiatives is that the program may serve a smaller population. This may result in a small sample size for evaluation, which can limit ability to conduct meaningful comparisons or analyses. Using qualitative evaluation methods is one approach for addressing this challenge.

The complex nature of childhood health and well-being. Social, behavioral, and environmental factors all contribute to the adoption of healthy behaviors in early childhood and influence early childhood health outcomes. Each of the factors contributing to early childhood health and well-being, and their complex relationship with one another, should be considered when planning evaluation efforts.

Time needed to assess health outcomes. Early childhood health promotion programs may be limited to a specific and somewhat short time frame, only capturing short-term outcomes and not the long-term outcomes associated with the programs. Additionally, evaluation efforts related to programs addressing policy or environmental changes may not capture long-term outcomes.

The diversity of sectors and stakeholders involved in early childhood health promotion and prevention programs. Ideally early childhood health promotion programs are developed and implemented by a diverse set of stakeholders, including healthcare providers, public health workers, teachers, nutritionists, and policymakers. Each individual provides a different view of the problem and the solution. What may be important to a policymaker may not be important to an instructor in a childcare center-based program, for example. While different views are beneficial to establishing well-rounded programs, they can create challenges in evaluation. Stakeholders may disagree on approaches and indicators that should be used in evaluation.

Challenges working with vulnerable populations. When working with vulnerable populations like children, it is important to consider ethical issues related to informed consent, confidentiality, and protection. Depending upon the intervention and the data being collected, parents or other caregivers may also need to provide informed consent.

Challenges of working with schools and childcare programs. Many early childhood health promotion programs are appropriate for implementation in early childcare settings. Children often spend significant portions of their day in these settings, which makes them a logical choice for implementing health promotion programs. However, centers with limited resources may not have the funding, staff, or time to support implementation of another program. It may be helpful if a program can offer an incentive (for example, continuing education credits for teachers), or if the program can demonstrate how it will help the school meet local or state standards or requirements.

For additional considerations in evaluating rural health promotion programs, see Evaluation Tools for Rural Health Promotion and Disease Prevention Programs in the Health Promotion and Disease Prevention Toolkit.