Incorporating Equity and Empowering Voices in Complex and Multi-Site Evaluations

Abstract Information: Health and human service programs are more effective when they match the needs of those they are serving and serve local communities with cultural sensitivity and humility. Evaluating programs is essential to understand the quality of program implementation and to make evidence-informed decisions to improve health outcomes. State programs for maternal and child health funded by the Maternal, Infant, and Early Childhood Home Visiting (MIECHV) Program vary across states and within states, as the needs of different counties and communities differ. MIECHV Programs implement voluntary evidence-based home visiting models with fidelity to serve priority populations (e.g., low income families, pregnant persons who have not attained age 21, families that have a history of child abuse or neglect, substance use, among others). At the federal, state, and local levels, MIECHV programs are interested in understanding what works for whom and in what context to inform program efforts, improve effectiveness of evidence-based home visiting service delivery, and reduce health disparities. This paper will describe how equity strategies are centered and incorporated across evaluation in the MIECHV Learning Agenda. We centered equity in funding announcements and supported grantees to consider equity at all phases of the evaluation process: funding, motivation, project design, data collection & sourcing, analysis, interpretation, and communication & distribution (weallcount.com). We will provide concrete examples of equity strategies that were applied in several Federally supported evaluation projects, including the Coordinated State Evaluations and the Multi-site Implementation Evaluation of Tribal Home Visiting for State-Tribal Collaborations. Specific equity strategies include: • engage local communities and service populations while planning and designing the study • develop and consult community advisory boards • conduct qualitative data collection such as consulting with program participants to better interpret and contextualize administrative data • collect data on community marginalization and experiences with racism • challenge program and evaluator biases, and acknowledged that program activities and evaluation studies are affected by root causes of historical and societal inequities • communicate findings back to evaluation participants, program staff, and communities. These strategies amplify and empower previously underrepresented and marginalized voices in evaluation and program decisions. Audience members will learn ways of incorporating equity into complex and multi-site evaluations through understanding the successes, challenges, and solutions in evaluations of a federally-funded, locally implemented maternal and child health program.