By Karen Fawcett, CEDIK Program Associate, and James Allen IV
Recently, the Appalachian Regional Commission (ARC) released an evaluative report of their 202 health projects funded over a six year period. The Community and Economic Development Initiative of Kentucky (CEDIK), together with UK College of Pharmacy, and UK Center for Business and Economic Research (CBER) assessed and provided recommendations for enhancing ARC’s health programming by analyzing past programming and conducting case studies. In addition, suggestions were presented to help guide future ARC funding strategies and priorities.
ARC invested over $30.9 million into health projects between the years 2004-2010. In this report, projects were grouped into three primary project types: Healthcare Access, Clinical Services and Health Promotion. The 90 Healthcare Access projects focused on expanding accessibility to healthcare providers by supporting the training of healthcare professionals or by directly increasing access to healthcare providers via telehealth or a new facility. The 45 Clinical Services projects sought to improve the quality of healthcare by improving or adding to the services that a healthcare facility offered. Finally, the 67 Health Promotion projects attempted to educate the public about healthy behaviors and encourage their participation. CEDIK used these categories, and others, to compare funding and impacts across different types of projects.
Appalachia is a diverse region made up of 420 counties and 13 states extending more than 1,000 miles, from southern New York to northeastern Mississippi, and is home to more than 25 million people. About 42% of the Appalachian Region’s population is rural, compared with 20% of the national population. The goal of ARC’s health projects are to improve health status throughout the region while providing extra support to particular areas of need. This large CEDIK evaluation of the health projects funded by the ARC contributes significant data, critiques and recommendations useful not only to ARC but to other Appalachian health care programs as well.
An online survey was utilized to help obtain updated project performance data and summarized results. Key findings from the online survey include:
- Over 60% of surveyed projects claimed that their work would not have been undertaken if not for ARC funding and over 95% of respondents claimed that, without ARC funding, the project would have been canceled, downsized, or delayed by more than a year.
- About 38% of surveyed projects created and/or retained jobs in the local economy, and employment of healthcare professionals in grantee organizations today is higher, on average, than before ARC funding.
- Almost 50% of surveyed projects claimed that the ARC project funding helped to attract additional government or philanthropic funding.
- About 92% of medical and other equipment purchased with ARC funding is still in good condition and has significant impacts on program participants and medical patients throughout Appalachia.
Additionally, 13 case studies relied on interviews and personal correspondence to explore the unique aspects of particular programs and view some reoccurring points pertaining to ARC’s health programming. Key findings from the case studies include:
- Sharing of best practices or technical expertise across similar project could improve cost efficiency and program effectiveness.
- Evidence of community support prior to funding was a clear indicator of a project’s success, large impacts and sustainability.
- Case studies reinforced that ARC is viewed as an important and helpful regional partner, especially due to their presence in each state.
Qualitative and observational data make valuable contributions to evaluations of any kind, and especially for a group of projects as diverse as those in ARC’s health programming. Throughout the evaluation, two themes emerged that may influence the discussion for the strategic direction for ARC’s health programming: 1) Large projects that create something new make it easier to attribute future outputs, and 2) Seed money for innovative but complex projects are essential because of the lack of initial support from other funding sources. Both themes suggest a strategic direction for ARC health projects that involves investing in a large or small new projects because it can simplify output and outcome tracking as well as attribution to the original investment.
For other organizations working in Appalachia, our findings suggest that evidence of community support is often linked with increased community awareness and likelihood of success for small projects. While for large projects, involvement of institutional leadership in the planning and implementation of the project is associated with an increased likelihood of success. Useful data for other groups interested in health programming within the Appalachian Region can be found in the ARC County Profiles created for this evaluation. All counties in the Appalachian Region are available to view by clicking on this link https://www.dropbox.com/sh/wsstsj0ynlmo0vp/AABeGKcD8Pob4cWCfUdg4fjga?dl=0.