Health in Action Program, Brazil: a Program Impact Pathways (PIP) analysis.

Abstract

The Health in Action Program was established in Brazil in 2010 to address the critical issues of health and nutrition among vulnerable children in the northeast and southeast regions of the country. By offering school-based nutrition education and increased access to nutritious foods from school gardens, the program has benefited more than 200,000 children aged 6 through 14 years in 430 schools and an additional 670,000 family and community members. The program is now expanding to reach an additional 260,000 students in 570 schools. The purpose of this study was to perform a Program Impact Pathways (PIP) analysis to identify Critical Quality Control Points (CCPs) and a suite of impact indicators in order to better understand and illustrate the impact of the program. The analyses of the PIP and the suite of impact indicators were conducted in collaboration with INMED Brasil's program management and evaluation team and the international evaluation team of INMED Partnerships for Children. INMED presented the results at a seven-country Healthy Lifestyles Program Evaluation Workshop held in Granada, Spain, 13-14 September 2013, hosted by the Mondelēz International Foundation, where it received feedback from evaluation experts. The PIP analysis enabled INMED to clarify the goals of the program, understand the ways in which program activities lead to stated goals, identify CCPs to monitor, and select achievable impact indicators, including changes in diet, physical activity, and knowledge, attitudes, and behaviors, as well as body mass index. While the program had previously demonstrated benefits through internal impact evaluation, the PIP Healthy Lifestyles Program Evaluation Workshop led to the identification of potential improvements in program processes and activities, as well as corresponding evaluation methodologies.