Beery et al. (2005) developed a conceptual framework that examines sustainability in a community health initiative led by a community partnership. This model, shown in Exhibit 4.5, conveys the transition from project initiation to intermediate and long-term outcomes, using a logic model framework. The model begins with activities (e.g., planning, assessment, evaluation) that contribute to the community’s overall capacity (boxes A, B, and C). In the transition column, a number of activities are then carried out by community health initiatives in order to sustain the initiative (box D). Such activities range from finding resources to creating systems for long-term evaluation and monitoring. The intermediate outcomes of the sustainability effort are those elements that could be sustained, including the partnership itself, the activities, and the community capacities. Finally, the long-term outcomes are the health outcomes.
Exhibit 4.5: Model for Evaluating the Sustainability of Community Health Initiatives
(a) For example, integrated services, data sharing or integrated data systems, results-based budgeting.
(b) For example, health literacy, resident leadership training, organizational development.
Reprinted from Beery et al. (2005).
Exhibit 4.5 This exhibit shows the Beery et al. (2005) sustainability logic model. The text references the boxes in the logic model. Box A is partnership or organizing entity. Box B is planning, development, and implementation activities. Box C is other community capacity building. Box D are the activities that are undertaken to increase the likelihood of sustainability. Box E is the sustainability of the partnership. Box F is the sustainability of activities. Box G is the sustainability of community capacity. Box H is the results, health outcomes. Box I is the influencing factors.
This model illustrates the various ways in which sustainability can occur within an initiative. The partnership (box E) and/or the major activities of the partnership (boxes F and G) can be sustained. Sustaining the partnership and/ or its activities results in the continuation of health outcomes.