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.