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A Communitywide Collaboration to Increase Enrollment, Retention, and Success in Evidence-Based Lifestyle-Change Programs in Racial and Ethnic Minority Populations


The content of this logic model is read from left to right with the following major headings: Inputs, Activities, and Outcomes. Inputs include 1) Partners: Missouri Department of Health and Senior Services, Gateway Region YMCA, Missouri Primary Care Association (MPCA), St. Louis County Department of Public Health, the St. Louis City Department of Health, Missouri Pharmacy Association (MPA), Integrated Health Network (IHN), Fit and Food Connection, and Evaluation team (Washington University in St. Louis/St. Louis University). 2) Staff includes Frontline workers (CHWs/CRCs/Lifestyle coaches), Managers, Evaluators, and Consultants. 3) Data systems include Electronic Health Records (MPCA, MPA), YUSA data system (YMCA), Efforts to outcomes data system (IHN), and REDCap. Activities include 1) Refer to lifestyle-change programs (LCPs) (Developed referral system across partners), 2) Build capacity of frontline workers (Developed training center to administer advanced trainings), and 3) Reduce barriers to participation and retention in LCPs. Screen for and provide resources in 4 key areas: Transportation (eg, Uber health, bus passes), Food access (eg, food vouchers, mobile markets, cooking demonstrations), Childcare (eg, YMCA childcare during classes), Internet support (eg, vouchers). Outcomes include short term, intermediate, and long term. Short term includes 1) Refer to LCPs (No. encountered, No. referred to LCPs), 2) Build capacity of frontline workers (No. who participated in trainings, No. of trainings completed, Skills gained, Satisfaction and perceived usefulness of trainings), 3) Reduce barriers to participation and retention in LCPs (No. of people encountered who have barriers, No. of referrals, No. of resources provided). Intermediate includes 1) Enrollment and retention in LCPs (DPP and BPSM) (No. of people enrolled, No. of classes attended, No. of classes completed, 2) DPP behavioral outcomes (Healthy eating, Physical activity), 3) BPSM behavioral outcomes (Blood pressure management, Knowledge of how to develop healthy eating habits). Long term includes 1) DPP outcomes (Patients that achieved at least 5% weight loss 12 months after class start, at least 4% weight loss and 150 minutes/week on average of physical activity, at least a 0.2% reduction in glycated hemoglobin A1c), 2) BPSM outcomes (Blood pressure control).


The Alliance logic model. Abbreviations: BPSM, blood pressure self-monitoring; CHW, community health worker; CRC, community resource coordinator; DPP, Diabetes Prevention Program; IHN, Integrated Health Network; LCP, lifestyle change programs; MPA, Missouri Pharmacy Association; MPCA, Missouri Primary Care Association; REDCap, Research Electronic Data Capture; YMCA, Young Men’s Christian Association; YUSA, YMCA of the United States of America.

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