Chronic disease prevention evaluation in Ontario's public health system: a qualitative needs assessment.

Abstract

Building evaluation capacity for chronic disease prevention (CDP) is a critical step in ensuring the effectiveness of CDP programming over time. In this article, we highlight the findings of the qualitative arm of a mixed-methods needs assessment designed to assess the gaps and areas of strength within Ontario's public health system with respect to CDP evaluation. We conducted 29 interviews and focus groups with representatives from25 public health units (PHUs) and analyzed the data using thematic analysis. We sought to understand what gaps and challenges exist in the Ontario public health system around CDP evaluation. Challenges facing Ontario's PHUs in CDP evaluation include variation and centralization of capacity to evaluate, as well as competing priorities limiting the development of evaluative thinking. Participating PHUs identified the need for evaluation capacity building (ECB) strategies grounded in an understanding of the unique contexts in which they work and a desire for guidance in conducting a complex and thoughtful evaluation. Moving forward, PHUs noted a desire for a strong system of knowledge sharing and consultation across the public health system, including through strengthening existing partnerships with community collaborators. These results support the case for ECB strategies that are adaptive and context-sensitive and equip PHUs with the skills required to evaluate complex CDP programming.