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Policy Evaluation

Purpose The Heart Disease and Stroke Prevention (HDSP) Program Evaluation Guides are a series of evaluation technical assistance tools developed by the Centers for Disease Control and Prevention (CDC), Division for Heart Disease and Stroke Prevention, to assist in the evaluation of heart disease and stroke prevention activities within states. The guides are intended to offer guidance, consistent definition of terms, and aid skill building on a wide range of general evaluation topics and selected specific topics. They were developed with the assumption that state health departments have varied experience with program evaluation and a range of resources allocated to program evaluation. In any case, these guides clarify approaches to and methods for evaluation, provide examples specific to the scope and purpose of the state HDSP programs, and recommend resources for additional reading. Some guides will be more applicable to evaluating capacity building activity and others more focused on interventions. Although examples provided in the guides are specific to HDSP programs, the information might also prove valuable to other state health department programs, especially chronic disease programs. Background Heart disease and stroke, the primary components of cardiovascular disease (CVD), are leading causes of death and disability in the United States. As the burden of heart disease and stroke continues to increase, these conditions are projected to remain the number one and two causes of death worldwide through the year 2020. In the United States alone, CVD affects 61.8 million Americans and claims nearly 1 million lives annually among people of all racial/ethnic groups and ages. In 1998, the U.S. Congress provided funding for CDC to initiate a national, state-based heart disease and stroke prevention program. As of July 2005, CDC funds heart disease and stroke prevention programs in 32 states and the District of Columbia. The priority areas for State activities are: • Increase control of high blood pressure. • Increase control of high cholesterol. • Increase awareness of signs and symptoms of heart attack and stroke and the need to call 9-1-1. • Improve emergency response. • Improve quality of care. • Eliminate disparities. Many factors increase the risk of developing heart disease and stroke. State-based programs must therefore use strategies that target multiple risk factors in many different settings, including health care settings, work sites, communities, and school worksites to be effective. States are encouraged to build capacity, use evidence-based approaches when they exist, and develop innovative interventions to address heart disease and stroke prevention. CDC-funded states are charged with providing evidence of capacity, of intervention, and of change within their state and are encouraged to build evidence for innovative and promising practices.