Maximizing the Potential of Mini-Grants to Promote Policy, Systems, and Environmental Changes: Outcomes and Challenges

Community-Driven Health Promotion: Evaluation of a Rural Microgrant Program

INTRODUCTION

Microgrants for health promotion have the potential to engage communities in designing and implementing place-based interventions to improve health and social outcomes. However, the evidence base around microgrants for health promotion is limited. This study presents the evaluation of a health service-funded microgrant program for health promotion in rural Australia.

METHODS

The evaluation framework was developed through a participatory approach and involved collaborative logic model building and co-prioritized evaluation questions with health service staff and grant recipients. Evaluation questions focused on participation, short-term outcomes, and the perceived value of program activities. Qualitative methods (reflexive thematic analysis) were used to answer the evaluation questions. Data sources included semi-structured interviews with grantees (n = 11) and the health service's health promotion team (n = 4), electronic field notes kept by the health promotion team (n = 50 documents), electronic progress reports completed by grantees (n = 6) and information and feedback forums (n = 2).

RESULTS

Since the program's inception in 2019, the health service has received 22 grant applications of which 15 were approved and 14 disbursed. Evaluation results show that grantees were community members with multiple roles, often with previous experience in applying for grants. Expected outcomes have been partially met, especially with regard to the program's aim of community empowerment. The most notable impact was the enhancement of participants' perception of and relationship with the health promotion team, as well as the creation of opportunities for community members such as exposure to art and bridging of social groups.

CONCLUSION

Microgrants represent a feasible way to increase health opportunities and foster community participation in the planning and delivery of health promotion programs. The key program activities identified and suggested improvements can help guide program replication and adaptation by other small organizations.

PUBLIC CONTRIBUTION

Community members who had previously received a health service grant were invited to participate in collaborative workshops and follow-up surveys to codesign the grant program evaluation framework, co-prioritize evaluation questions and guide the results' dissemination plan.

Mobilizing community-driven health promotion through community granting programs: a rapid systematic review

BACKGROUND

Effective health promotion responds to the unique needs of communities. Community granting programs that fund community-driven health promotion initiatives are a potential mechanism to meet those unique needs. While numerous community health-focused programs are available, the various strategies used by granting programs to foster engagement, administer grants and support awardees have not been systematically evaluated. This rapid systematic review explores the administration of community granting programs and how various program components impact process and population health outcomes.

METHODS

A systematic search was conducted across three databases: Medline, SocINDEX, and Political Science Database. Single reviewers completed screening, consistent with a rapid review protocol. Studies describing or evaluating community granting programs for health or public health initiatives were included. Data regarding program characteristics were extracted and studies were evaluated for quality. A convergent integrated approach was used to analyze quantitative and qualitative findings.

RESULTS

Thirty-five community granting programs, described in 36 studies, were included. Most were descriptive reports or qualitative studies conducted in the USA. Program support for grant awardees included technical assistance, workshops and training, program websites, and networking facilitation. While most programs reported on process outcomes, few reported on community or health outcomes; such outcomes were positive when reported. Programs reported that many funded projects were likely sustainable beyond program funding, due to the development of awardee skills, new partnerships, and securing additional funding. From the perspectives of program staff and awardees, facilitators included the technical assistance and workshops provided by the programs, networking amongst awardees, and the involvement of community members. Barriers included short timelines to develop proposals and allocate funds.

CONCLUSIONS

This review provides a comprehensive overview of health-related community granting programs. Grant awardees benefit from technical assistance, workshops, and networking with other awardees. Project sustainability is enhanced by the development of new community partnerships and grant-writing training for awardees. Community granting programs can be a valuable strategy to drive community health, with several key elements that enhance community mobilization.

REGISTRATION

PROSPERO #CRD42023399364.

Implementation During a Pandemic: Findings, Successes, and Lessons Learned from Community Grantees

Funding communities through mini-grant programs builds community capacity by fostering leadership among community members, developing expertise in implementing evidence-based practices, and increasing trust in partnerships. The South Carolina Cancer Prevention and Control Research Network (SC-CPCRN) implemented the Community Health Intervention Program (CHIP) mini-grants initiative to address cancer-related health disparities among high-risk populations in rural areas of the state. One community-based organization and one faith-based organization were funded during the most recent call for proposals. The organizations implemented National Cancer Institute evidence-based strategies and programs focused on health and cancer screenings and physical activity and promotion of walking trails. Despite the potential for the COVID-19 pandemic to serve as a major barrier to implementation, grantees successfully recruited and engaged community members in evidence-based activities. These initiatives added material benefits to their local communities, including promotion of walking outdoors where it is less likely to contract the virus when socially distanced and provision of COVID-19 testing and vaccines along with other health and cancer screenings. Future mini-grants programs will benefit from learning from current grantees' flexibility in program implementation during a pandemic as well as their intentional approach to modifying program aspects as needed.