Addressing Systemic Inequities: An Evaluation of the Resilience Catalysts in Public Health Program.

Abstract

CONTEXT Resilience Catalysts (RC) in Public Health provides local health departments (LHDs) with a process and technical assistance (TA) to operationalize the Community Health Strategist (CHS) role, foster equity, and support community resilience through policy, practice, and program change across multiple sectors. OBJECTIVES This evaluation sought to (1) identify essential elements of the RC process and TA that help LHDs address the systemic drivers of adversity and inequity, and (2) expand understanding of RC's preliminary impact and inform implications for theory, practice, and funding in the post-COVID context. DESIGN The mixed-methods evaluation incorporated online surveys and semi-structured interviews. Key themes and takeaways were identified using framework analysis, constant comparison analysis, and descriptive statistics. SETTING The evaluation was conducted in 12 cities and counties across the United States, including California, Colorado, Florida, Iowa, Kentucky, Maryland, Massachusetts, New Jersey, North Carolina, Ohio, Tennessee, and Washington. PARTICIPANTS Survey participants consisted of 29 representatives of 11 RC sites. Interview participants included 33 individuals: 19 representatives of 9 RC sites and 14 individuals representing RC TA providers and funders. MAIN OUTCOME MEASURES The evaluation measured outcomes related to collaborative engagement, addressing inequity, systems change, knowledge change, ability to work within a local political and community context, sustainability, and scalability. RESULTS Evaluation results demonstrate outcomes related to community engagement, expansion of system-level thinking, advancing health and racial equity, clarity and understanding of RC process, building LHD and partners' capacity and skills needed to embody the CHS role. CONCLUSIONS The RC process prepared LHDs to operationalize the CHS role by providing the knowledge, skills, and capacities needed to understand root causes of adversity and inequity, address structural racism as a public health issue, and develop collaborative plans for addressing root causes.