Jennifer Leeman, School of Nursing
Background. Local policy change is essential to creating environments that support healthy behaviors. Yet, little is known about what implementation strategies best support community efforts to change local policy. Policy change is uncertain and may take years to achieve, limiting efforts to measure implementation strategy effectiveness. Measuring intermediate outcomes overcomes this challenge by providing interim markers of communities’ progress while also advancing understanding of “what works, for whom, and under what conditions.” Purpose. We integrated implementation science and policy change theories to create a framework for evaluating policy implementation strategy effectiveness. We developed an intermediate outcome measure (Policy Change Process Completion, [PCPC]) and adapted existing measures to assess contextual factors and progress toward policy change, using local policy governing retailer tobacco marketing as our test case. Methods. PCPC development included formative research on core processes and activities required to change policy and translation of findings into a structured interview guide. We pilot tested measures with 30 tobacco control partnerships at 6 and 12 months following receipt of implementation strategies. Results: The final PCPC assesses 24 activities within five core policy change processes: (1) engage partners, (2) document local problem, (3) formulate evidence-informed solution, (4) raise awareness of problem and solution, and (5) persuade decision makers to enact new policy. Findings include feasibility of data collection and initial findings on intermediate outcomes, salient contextual factors, and progress toward policy change. Conclusions: Future research will test measures’ reliability and hypothesized relationships among constructs and also assess their applicability to other policies supportive of healthy behaviors.