Systematic Review of Metropolitan Community Health Service Evaluations

Staff involved: Fran Baum, Gwyn Jolley, Catherine Hurley and Megan Kyriacou

This systematic review commenced in February 2003 following the launch of the report Investing in Community Health Services: Finding the evidence for effectiveness . This stage aims to design, conduct, report and disseminate the findings of a systematic review of evaluations conducted in community health services in metropolitan South Australia. This will facilitate an analysis of the evidence for the effectiveness of community health services.

The purpose of conducting a systematic review is to facilitate the aggregation of the evidence from a number of evaluations into one document that allows the evidence to be analysed collectively rather than individually. If this process could be applied to community health evaluations it would help to build a credible body of knowledge on the effectiveness of community health services that is greater than the sum of the parts.

Research objectives:

  1. To identify and document CHS evaluations
  2. To trial the application of systematic review and analysis to the evaluations
  3. To assess the effectiveness and appropriateness of systematic review to CH evaluations
  4. To determine areas in which common assessment tools could be used by CHS
  5. To contribute to an evidence base for CH services and approach

The SACHRU team is working closely with a working group made up of representatives from metropolitan community health services and DHS.

The first step was to draft a detailed plan for the research including the inclusion criteria for evaluation reports, a systematic review framework, and the review process.Ninety-three evaluation reports meeting the inclusion criteria were identified. Each report has been reviewed by a SA community health practitioner or SACHRU researcher and by an external consultant from NSW, Denise Fry. View South Australian Community Health Research Unit Effectiveness of Community Health: Systematic Review Data Sheet

In response to requests from the community health services representatives on the working group, SACHRU researchers visited each service to conduct a workshop investigating the promoters and barriers to evaluation in the community health sector.

Early findings from the review revealed that most of the evaluated interventions were small-scale group programs or community initiatives. Participant feedback sheets were the most common data collection method although most reports described more than one method.

There is a large amount of evaluation work occurring in South Australian community health centres. Reports scored well in describing the intervention but were less comprehensive in discussing assessment of longer term outcomes, transferability and sustainability.