Evaluation of the

Racial and Ethnic Approaches to

Community Health (REACH)
Cabarrus County, NC
UNC-Greensboro
HEA 625
December 7, 2015

Mikafui Antonio-Obese
Rita Dominguez
Laura Rolke

Table of Contents
Section 1: Conceptualization of Evaluation................................................. 2
Section 2: Program Description.................................................................... 4
Section 3: Evaluation Plan............................................................................. 9
Section 4: Reporting Plan.............................................................................. 10
Section 5: Detailed Budget ............................................................................ 11
Section 6: Detailed Timeline ......................................................................... 13
References ........................................................................................................15

Section 1: Conceptualization of Evaluation

What purpose(s) will be served by the evaluation?
The evaluation will help determine if the REACH program effectively increased access to
healthy foods to members of Cabarrus County. The REACH program has many components, but
this evaluation will be focused on increasing access to environments with healthy food and
beverages. The evaluation proposal is to propose interventions that would:

Implement mobile farmers markets that accept SNAP/EBT in target neighborhoods

Increase the number of existing farmers markets that accept SNAP/EBT
Encourage corner stores, dollar stores to stock and promote healthy food and beverage items
Encourage schools, parks, community and government agencies to adopt healthy food policies
What broad questions will be addressed by the evaluation?
The evaluation will help determine the effectiveness of the Cabarrus County REACH
program to create options for a healthier food landscape for minorities. The goal is to see if the
program increases the options for healthy food in the Cabarrus County area. It seeks to increase
the number of mobile farmers markets, farmers markets that accept SNAP/EBT, corner stores,
and dollar stores that sell healthy foods and beverages. It also seeks to provide information to
schools, parks, community, and government agencies to increase the likelihood they will institute
healthy food policies.
Who are the key stakeholders?
The key stakeholders are community members, healthcare system, community health
centers/clinics, faith communities, schools, and community and government agencies. The focus
is on minority populations (Hispanic and African American), but this encompasses many large
community groups.
What assumptions are being made?

Latino/Hispanics are at greater risk to live in poverty

African Americans and Latino/Hispanics have less access to healthy food options
Disparities exist among minority groups
Environment influences about food and beverage choices people make
Socio economic disadvantages among minorities impact health outcomes
Limited access to fresh foods affect low income communities and communities of color
Inability to obtain fresh food disproportionately affect low income families and people of color

What are the major contextual factors that need to be considered?

The accessibility of resources can be affected by many factors:
Agencies and institutional factors and how well they work to provide services
Political Factors- support of policies that support the accessibility of services and encourage
healthy behaviors
Environmental factors that affect the delivery or sustainability of the program and resources
Economic factors that support local economy so more families have economic resources to
access services and support a healthier environment
Legal factors that can affect certain groups access services

Section 2: Program Description

Evaluators should clearly describe the program to be evaluated. The evaluator should include a
program logic model in this section.
What is the overall purpose of the program?
The REACH (Racial and Ethnic Approaches to Community Health) program is a national
project that seeks to reduce health disparities with minority residents developed by the Center for
Disease Control and Prevention (CDC). It seeks to involve members of the local community to
reduce health gaps with treating heart disease, diabetes, breast and cervical cancer, infant
mortality, hepatitis B, tuberculosis, asthma, and obesity. REACH seeks to address these by
focusing on tobacco use and expose, physical inactivity, poor nutrition, and lack of access to
chronic disease prevention. Cabarrus County, North Carolina received a comprehensive
implementation grant from the CDC and they are using it to focus on healthy foods and
beverages, chronic disease prevention, and physical activity opportunities.
What are the program goals and objectives?
There are three main goals for the REACH program in Cabarrus County:
Increase access to environments with healthy food and beverages
Increase prevention, risk reduction or management of chronic disease through clinical and
community linkages
Increase access to physical activity opportunities

Who is the target audience?

The program focuses on minority populations, specifically African Americans and
Hispanics, in Cabarrus County. The REACH program was created to target health disparities so it
is important focus on the intended population.
People living in food deserts are also a priority for the REACH program. According to
the 2012 Cabarrus County Environmental Health Assessment, there are four census tracts
considered food deserts in the county. As of 2012, 9.35% of the population was considered low
income and lived more than a mile away from a grocery store (Cabarrus Health Alliance, 2012).
Where is the program intended to be implemented?
The program is implemented in Cabarrus County community settings. Each objective of
the healthy food and beverage environment goal focuses on a different setting. Mobile farmers
markets with SNAP/EBT will focus on reaching identified target neighborhoods; Grace Lutheran
Church and St. Joseph Catholic church are current identified mobile market sites. Farmers
markets are intended locations to increase SNAP/EBT benefits. Corner and dollar stores (like
Center City Maxx, Dannys Place, and Mi Pais Latino Market) will be targeted to increase
healthy food and beverage selection. Also schools, parks, community and government agencies
will be encouraged to adopt healthy food policies.

Has the program undergone previous evaluations? If so, what were the results?
The specific Cabarrus County REACH program has not yet been evaluated, but other
communities have evaluated their applications of the REACH program. In REACH
communities that concentrated on cardiovascular disease or diabetes, it was found that the
percentage of adults who reported eating five or more fruits and vegetables a day increased 3.9%
among African Americans and 9.3% among Hispanics (CDC).
Locally, the Charlotte REACH 2010 Coalition targeted heart disease and diabetes in
African Americans living in the Northwest Area. In 2001, a neighborhood farmers market was
created to provide spaces for local vendors to sell their produce from spring to fall (CDC, 2007).
It is managed by a local neighborhood group and averages about 350 customers a week (CDC,

2007). Since the market opened, 73% of residents said they are eating more fruits and vegetables
each day and 67% said they have reduced the amount of fat in their diet (CDC, 2007). There are
three published review articles on the effectiveness of the program in Charlotte. Participants in
the program reported an increased knowledge of preventative health behaviors, development of
health-related skills, and diffusion of knowledge to their family (DeBate, 2004). Community Lay
Health Advisors were credited to the success of the program (DeBate, 2004).
Logic Model Description
The first year of the REACH program has 4 goals to work towards: increasing the
number of mobile vending carts that accept SNAP/EBT, increasing the number of grocery stores
that sell healthy food and beverage options, increasing the number of recreation areas that
implement new healthy food policies, and increasing the number of messages on access to
healthy food and beverage options. Each goal is outlined below:
The first goal is to increasing the number of mobile vending carts that accept SNAP/EBT
by identifying census tracts that have low access to fresh produce. From this, identify churches
that have high interest in a mobile market and work to create a business plan with Go Go Fresco
to expand in Cabarrus County. The goal is to create 3 of these mobile vending carts in the county
and develop promotional materials to distribute information.
To increase the number of grocery stores that sell healthy food and beverage options,
Healthy Cabarrus will work with targeted neighborhoods. Community members will be
surveyed on their preferred healthy foods and staff will help store owners with information to
improve shelving, signage, and healthy recipes to promote new healthy items. The program also
plans to work with a local merchandiser has product placement expertise. After implementation,
the sales data of the new products will be evaluated.
Increasing the number of recreation areas that implement new healthy food policies will
first be done by changing the food policy at the Kannapolis Intimidators stadium. In later stages,
it will focus on improving vending machines, but changing concession stands is also an option.
Baseline data on existing food environments at recreational areas will be collected and new
policies will be developed. The Intimidators changes will be developed and then implemented.
To evaluate the results of the changes, the sales of data from new healthy products will be
assessed.

The final goal is to increase the number of messages on access to healthy food and
beverage options. A social marketing campaign will using billboards, as well as promotional
materials in local magazines, church and community bulletin boards, and community
newsletters. The number of developed materials, the number of emails to media contacts, and the
number of materials disseminated will be evaluated.

Program Description

Evalu
Monitoring

Goals/Objectives

Activities

Results

Evidence of Activities
Identify census tracts with low access to
fresh produce

Increase the number of

Mobile Vending Carts that
accept SNAP/EBT

Increase the number of

SNAP/EBT accepting Mobile
Vending Carts from 0 to 3.

Identify 3 community sites that can support

a Mobile Vending Cart.
Output/measure of number of mobile
vending carts
Number of developed promotional
materials
Output/measure of number of stores

Increase access to
environments with
healthy food and
beverages

Increase the number of

grocery stores that sell
healthy food and beverage
options.

Increase the number of

grocery stores from 1 to 4.

Increase the number of

recreation areas that
implement new healthy
food policies

Implement a healthy food

policy at the Kannapolis
Intimidators stadium

Output/measure of the number of new food

items
Sales data of new healthy items
Output/measure of number of the number
of recreation areas with healthy food
policies
Develop and implement healthy food
policy at Intimidators stadium
Sales data of new healthy items

Increase the number of

messages to public on
access to healthy food and
beverage options

Increase the number of media

messages from 0 to 1

Number of developed promotional

materials
Number of emails to media contacts
Number of billboards, posters
disseminated, and inserts disseminated

Section 3: Evaluation Plan

Identify the specific evaluation questions
Did the number of Mobile Vendor Carts that accept SNAP/EBT increase from 0 to 3 in target
neighborhoods?
Did the number of grocery stores that sell healthy foods and beverage increase from 1 to 4?
Did the number of recreation areas that have healthy food policies from 0 to 1?
Did the number of promotional media messages on healthy food options increase from 0 to 1?
Experimentation Design
Mobile Vendor Carts
Experimental design: pre/post measures of mobile vendor carts
Intervention: the implementation of mobile market carts at community sites in target
neighborhoods
Qualitative: focus group following evaluation to provide ongoing support
Grocery Store Initiative
Experimental design: pre/post measures of number of grocery stores, pre/post sales data
Intervention: implementation of new food items and marketing materials in grocery stores,
accompanied by training with store owners
Qualitative: interviews with store owners and customers on what food items would be best
Sustainability: follow-up visits with ongoing support provided.
Recreation Areas
Experimental design: pre/post measures of number of recreation area policies, pre/post sales data
Intervention: implementation of a healthy food and beverage policy at the Kannapolis
Intimidators stadium.
Qualitative: engagement of community and staff on food decisions.
Sustainability: follow-up visits with resources provided; potential to expand to other concession
stands in the area
Promotional Messages
Experimental design: pre/post measures of number of promotional messages
Intervention: promotion of community-wide social marketing efforts to engage community
members.

Evaluation Crosswalk
Data Source

Evaluation Question
Implementation
Did the numbers of promotional
media on healthy food options
increase from 0 to 1?

Collected baseline info from

Pre- intervention
data on media
materials on healthy
food options.
Pre-intervention
survey on knowledge
on healthy food
choices.

Outcome
Did the number of recreation
areas that have healthy food
policies increase from 0 to 1?

Pre-intervention survey.

Impact
Did the number of mobile vendor
carts that accept SNAP/EBT
increase from 0 to 3 in target
neighborhoods?

Pre-intervention survey.

Impact
Did the number of grocery
stores that sell healthy foods
and beverages increase from 1
to 4?

Pre-intervention survey.

Post Intervention info will be collected

from

Pre and post intervention survey

on knowledge about healthy food
and vegetables for participants of
the program.
Data on correspondence to media
contacts.

Data on sales of healthy food at

recreation areas.

Survey mobile vendor cart

operators in target neighborhoods.

Survey community members in

target neighborhoods.

Sales on healthy foods at the

grocery stores.
Survey of community members on
their food choices.

Section 4: Reporting Plan

An executive summary will be presented that will contain a brief introduction and
purpose of the evaluation, major findings and recommendations with the necessary supporting
documentation. The report will include a detailed presentation of the evaluation plan, data
collection instruments, methods used to analyze and interpret the data. Availability of the reports
and documents will be available in the website or who requests a copy. The REACH grant is
funded by the CDC so the evaluation results will be submitted to show progress with the grant.
The introduction of the executive summary will include the rationale for the evaluation. It
will also include any limitations or disclaimers will be make at the beginning of the report to
clarify what the evaluation is and is not in order to protect the client and evaluators (Fitzpatrick,
Sanders & Worthen, 2011). Also, important to include the focus of the evaluation and questions
the evaluation will answer. This is an opportunity to add the intention of the program, a logic
model and program theory describing the main parts, goals and intended outcomes, staffing and

people impacted by the program and include any supporting documents in the Appendix section
(Fitzpatrick et al., 2011).
The presentation of the evaluation results will include organized and detailed summary
using simple tables and displays for easy interpretation for the target audience. Easy to
understand reporting that will answer the evaluation questions addressed in Section 3.
Finally, a summary of the main conclusions of the evaluation and conclude with
recommendations whether the program should be expanded to other communities, revisions or
improvements.
Community presentations of the findings will be conducted and information will be
disseminated throughout the community at large. The plan includes to create a visual display,
such as a PowerPoint presentation, of the evaluation report that is tailored to the target audience
to facilitate dialogue, interaction and mainly understanding of the reporting and obtaining
suggestions comments and ideas (Fitzpatrick et al., 2011).

Section 5: Budget
Total CDC award (annual, first of 3 years): $836,147
Personnel Expenses
Role

Total Months

Base Salary

Fringe
Benefits

Total

Program Manager

12

$110,000

$20,900

$130,900

Public Information
Officer

12

$60,000

$11,400

$71,4000

Program Coordinator

12

$45,000

$8,550

$53,550

Program Coordinator

12

$45,000

$8,550

$53,550

Program Coordinator

12

$45,000

$8,550

$53,550

$305,000

$57,950

$362,950

Total

Travel

Year 1

In-Kind

Total

Statewide & National

$10,300

$0

$10,300

Local

$3,024

$0

$3,024

Total

$13,024

$0

$13,024

Year 1

In-Kind

Total

General Office Supplies

$3,000

$0

$3,000

Wireless Internet

$2,400

$0

$2,400

Printing

$1,800

$4,200

$6,000

Computers

$4,278

$0

$4,278

Office Furniture

$0

$3,500

$3,500

Total

$11,478

$7,700

$19,178

Year 1

In-Kind

Total

Evaluator

$80,000

$0

$80,000

Community Garden Trainer

$3,000

$0

$3,000

Web-based Community
Resource Portal

$18,000

$0

$18,000

Merchandiser

$8,200

$0

$8,200

City of Concord

$40,000

$0

$40,000

City of Kannapolis

$40,000

$0

$40,000

Safe Routes to School

Action Plan

$48,000

$0

$48,000

Concord Kannapolis Area

Transit (CKAT)

$10,000

$0

$10,000

Food Recovery Program

$10,000

$0

$10,000

Supplies

Contractual Expenses

Cabarrus County Active

Living and Parks

$10,000

$0

$10,000

Total

$267,200

$0

$267,200

Year 1

In-Kind

Total

Community Garden
Initiative

$10,000

$0

$10,000

Joint Use Agreements

$15,000

$0

$15,000

Healthy Food Policy

Implementation

$8,000

$0

$8,000

Farmers Markets
Enhancements

$8,000

$0

$8,000

Healthy Corner Store

Initiative

$9,000

$0

$9,000

Exercise is Medicine

$3,000

$0

$3,000

Coalition Meeting Supplies

$3,000

$0

$3,000

Total

$56,000

$0

$56,000

Year 1

In-Kind

Total

Billboards

$18,000

$0

$18,000

Professional Social
Marketing Print Media

$6,000

$0

$6,000

Professional External
Printing

$2,625

$0

$2,625

Electronic Social Marketing $10,000

Materials

$0

$10,000

Environmental Health
Promotion

$0

$700

Other

Communications

$700

Total

$37,325

$0

$37,325

Year 1

In-Kind

Total

Indirect Expenses

Indirect Costs

$80,470

$80,470

Total: $836,147

Section 6: Timeline
Proposed Timeline
Task

2014
Oct

Nov

2015
Dec

Jan

Feb

Mar

Apr

May

Jun

Jul

Aug

Sep

Jun

Jul

Aug

Sep

Mobile Vending Carts

Baseline # of
mobile markets
collection
Identify sites to
support
Create business
plan
Develop marketing
materials
Establish 3 sites
Evaluate reach of
mobile markets

Grocery Stores
2014
Oct
Baseline # of
stores collection
Identify potential
stores
Develop training
guidelines for store
owners
Measure # of new

Nov

2015
Dec

Jan

Feb

Mar

Apr

May

food items
Measure # of
marketing
materials
Review pre/post
sales data

Recreation Areas
2014
Oct

Nov

2015
Dec

Jan

Feb

Mar

Apr

May

Jun

Jul

Aug

Sep

Jun

Jul

Aug

Sep

Baseline # of areas
collection
Research on food
environments in
parks
Complete scan of
current
Intimidators
stadium
Develop healthier
policy for
Intimidators
Promotion
materials installed
Implement food
policy
Analyze pre/post
sales data

Promotional Messages
2014
Oct
Conduct
assessment on
social marketing
campaigns
Engage focus
groups
Identify vendors
Develop
promotional
materials

Nov

2015
Dec

Jan

Feb

Mar

Apr

May

Emails with media

contacts
Implement
marketing
materials
Evaluate
marketing
materials

References
1.
Cabarrus Community Planning Council. (2012). 2012 Cabarrus County Community Needs
Assessment. Retrieved from http://www.cabarrushealth.org/documentcenter/view/111
2.
Cabarrus Health Alliance. (2012). 2012 Cabarrus County Environmental Health
Assessment. Retrieved from http://www.cabarrushealth.org/DocumentCenter/View/110
3.
National Center for Chronic Disease Prevention and Health Promotion. Making Healthier
Living Easier REACH. Retrieved from http://www.cdc.gov/nccdphp/dch/pdfs/00-making-lifeeasier-reach.pdf
4.
Centers for Disease Control and Prevention. The Power to Reduce Health Disparities:
Voices from REACH Communities. Atlanta: U.S. Department of Health and Human Services,
Centers for Disease Control and Prevention; 2007.
5.
Centers for Disease Control and Prevention. Investments in Community Health Racial and
Ethnic Approaches to Community Health (REACH). Atlanta. Retrieved from
http://www.cdc.gov/nccdphp/dch/programs/reach/pdf/2-reach_factsheet-for-web.pdf
6.
DeBate, R., Plescia, M., Joyner, D., & Spann, L. (2004). A qualitative assessment of
Charlotte REACH: An ecological perspective for decreasing CVD and diabetes among African
Americans. Ethnicity & Disease, 14(3), 77-82.
7. Fitzpatrick, Jody L., James R. Sanders, and Blaine R. Worthen. (2011). Program Evaluation
Alternative Approaches and Practical Guidelines. 4th ed. Boston: Pearson, Allyn and Bacon