Evaluation of HealthConnect in Our Community: Final Report

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Abstract

In 2005 The Children's Trust of Miami-Dade County initiated HealthConnect in Our Community, designed to improve the health of children and adolescents in the county. The program uses community workers to reach out to underserved children and their families. The Urban Institute and three local consultants conducted a formative assessment the program's first year of operation. In a six-day site visit we interviewed 26 individuals, observed program operations in 19 separate locations, and conducted five focus groups, three with clients and two with program staff. This report summarizes the findings from the evaluation, and provides recommendations for improving the program.

Executive Summary

In 2005, the Children’s Trust of Miami-Dade County initiated the HealthConnect program, designed to improve the health of children and adolescents in the county. One of three components of HealthConnect is HealthConnect in Our Community (HCiOC). HCiOC—through contracts with six health and social service community-based organizations around the county—uses two types of workers (community health workers and health navigators) to reach out to underserved children and their families. Community health workers (CHWs) perform community outreach to identify families that need assistance or to give them health education. They either provide that assistance directly or refer the family to health navigators (HNs) for assistance. HNs, in turn, help families by providing enrollment assistance or health navigation (i.e., helping the family make appointments for health care).

In 2006, the Trust contracted with the Urban Institute and three local consultants to conduct a formative assessment of HCiOC in its first year of operation. We conducted a six-day site visit in February 2007 during which we interviewed 26 key informants across Miami-Dade, observed program operations in 19 separate locations, and conducted five focus groups, three with clients and two with program staff.

The key findings and recommendations from this evaluation are presented below, with more detail presented in the body of the full report:

Findings

1. The HCiOC program was implemented relatively rapidly, building well on precursor efforts. The program design is appropriate to filling an important gap in services in Miami-Dade County.
2. HCiOC contractors have generally attracted a committed staff who have the experience and skills for their jobs, although there is a need for more training in some areas.
3. The program is culturally sensitive, which is critical for reaching the most underserved children and families in Miami-Dade.
4. Clients of the program are very satisfied with the HCiOC services they receive (although they usually do not recognize the program by name).
5. There is substantial variation in the way the HCiOC “model” is implemented across contractors, resulting in unevenness in the type and quality of program services.
6. The current reporting systems for the HCiOC provide inconsistent and, at times, misleading results. The reporting also provides some unintended incentives to provide less intensive services than desirable.

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