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Infant Mortality
Hickory Hill Community Redevelopment Corporation
Works to Reduce Infant Mortality

In 2008, the Center for Research on Women (CROW) began work to evaluate the March of Dimes Community Voice program's effectiveness in Shelby County. Funding was received for the first three years, but the program was temporarily halted. In 2011, the state of Tennessee and Shelby County reinstated Community Voice with a new lead agency, Hickory Hill Community Redevelopment Corporation (HHCRC). Immediately following the reinstatement of funding CROW was once again charged with evaluating the effectiveness of the program in Shelby County.

In January 2012, CROW began administering evaluation surveys for Community Voice training groups facilitated by HHCRC. CROW administered questionnaires to participants which assessed their personal family situation, gave them an opportunity to describe their Community Voice training experience, and evaluated what they learned in the training sessions through pre and post knowledge tests related to the material presented. CROW analyzed responses on the post knowledge test to determine how to improve the curriculum and its delivery.

Participants who scored 80% or better on the knowledge post-test became Lay Health Advisors (LHAs). After certification LHAs were asked to disseminate the information they learned in their communities. LHAs were also asked to complete Contact Reporting Forms (CRF's) to report on their community interactions, which enables CROW to track penetration of the intervention.

CROW has recently released Taking it to the People: The 2013 Community Voice Program Evaluation Report

 Reducing Infant Mortality-UPDATE!

Lay Health Advisors (LHA) have been working tirelessly to spread the word about the high rates of infant mortality in our Memphis community.  In the 2009 calendar year Community Voice trained 447 new LHAs.  Of those trained, 26% lived in the targeted zip codes with the highest rates of infant mortality.  During the 2009 calendar year LHAs educated a total of 2,865 people in the Memphis community. Since the beginning of the program 5,329 contact reporting forms (forms our LHAs fill out to document their contact with the community) have been returned, and a total of 15,000 people  (including individual contacts and group presentations) have been educated about infant mortality! 

Thank you Lay Health Advisors! 

Reducing Infant Mortality through Community Voice

In 2008 the Center for Research on Women began work on a comprehensive, four-year evaluation of Community Voice (CV), a grassroots educational program designed to reduce and prevent infant mortality. CV is administered locally by the Tennessee March of Dimes.  The educational program and its evaluation are part of Governor Phil Bredesen's statewide Infant Mortality Initiative.  The initiative in Memphis is coordinated by the Shelby County Office of Children and Youth.

CROW is working in partnership with the UofM Center for Community Building and Neighborhood Action (CBANA) to evaluate the program's effectiveness in Shelby County.

Based on a curriculum and trainer’s guide developed by the Community Voice Program of the South Central Perinatal Council of Virginia, lay health advisors are recruited and trained to take the information they receive throughout the community.

Premised on the understanding that local, indigenous, and tacit knowledge about pregnancy and parenting motivates behavior, Community Voice is intended to diffuse new knowledge working through indigenous and credible social networks and pivotal persons in those networks.

The vision for Community Voice is that it will lead to better birth outcomes in communities where new knowledge is diffused and healthier behaviors adopted.  Better birth and maternal outcomes (lower incidence of prematurity and low birth weight,  diminished infant mortality, and other indicators that may be identified) are expected to be a moderate to longer term effect, so that while these outcomes will be baselined and tracked during the three year period, we expect to more fully document process and interim outputs.

In just one year, over 200 lay health advisors (LHAs) have been certified through the Community Voice program and those LHA's have reported sharing their new knowledge with over 2,000 people in the Memphis community.


The Evaluation Process

In this project, CROW and CBANA are using an empowerment evaluation protocol where contextual knowledge that evaluators might bring to bear as the program is being implemented is shared with program staff and volunteers, and where community-based participants share in the interpretation and fine-tuning of the evaluation process.

Evaluation components include:

Process evaluation: Participant observation and standard field methods documenting design, implementation, and acceptance of the training and other aspects of Community Voice.

Standardized pre and post-testing for training participants (knowledge, beliefs and attitudes, and intended behaviors), along with activity logs designed to document actual changes in behavior and fidelity to the diffusion concept.

Asset mapping and other contextual analysis to grasp neighborhood inputs (strengths, weaknesses, opportunities and threats) that may impinge on the successful implementation of Community Voice among particular social networks or in particular neighborhoods (risk and protective factors for successful implementation or diffusion.)

Measures of diffusion and penetration, including the activity log and perhaps other measures such as a systematic survey of network members/neighborhood residents.

Tracking birth and maternal outcomes from 2007 baseline through 2010 (with final report in 2011.) 


Community Voice 2013 Report

Taking it to the People: The 2013 Community Voice Program Evaluation Report

CV 2010
2010 March of Dimes Community Voice Evaluation Final Report
2010 March of Dimes Community Voice Evaluation Final Report Tables and Figures

CV 2009 Report
2009 March of Dimes Community Voice Evaluation Annual Report (includes appendices A and B)
Tables and Figures
Appendices C--Y

CV Report 2008

2008 March of Dimes Community Voice Evaluation Annual Report

Appendix A: Evaluation Methods
Appendix B: Evaluation Timeline
Appendix C: Logic Model
Appendices D-F:  Surveys
Appendices G-I:  Interview Protocols
Appendices J-Q:  Infant Mortality Maps

Click here to watch Tanya Lee Lewis' documentary on infant mortality called Crisis in the Crib.


Community Voice Brochure

March of Dimes Website


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Last Updated: 2/24/14