A city-wide health promotion programme evaluation using EQUIHP: Jerusalem Community-Academic Partnership (J-CAP)

Background: While health promotion initiatives are common, too little is known about their quality, impact and sustainability. Fragmentation between sectors exists and programme evaluation initiatives lack consistency, making comparison of outcomes challenging. Methods: We used a 'snowball' methodology to detect health promotion programmes (HPPs) in the Municipality of Jerusalem, excluding those in schools. The European Quality Instrument for Health Promotion (EQUIHP) was adapted and used to examine programme quality. The tool was pre-tested among stakeholders, and translated into Hebrew and Arabic between March and December 2017. Trained research assistants collected information on four domains using in-person interviews: (i) compliance with international principles of HPPs, (ii) development and implementation, (iii) project management and (iv) sustainability of programmes. Results: Overall, 93 programmes, including 33 670 participants, were ascertained and evaluated. The majority of HPPs (54.8%) addressed nutrition and physical activity, with 58.1% targeting the non-orthodox Jewish population and 68.8% aimed at both sexes. Cronbach's alpha scores were 0.968 for the entire EQUIHP tool and 0.802, 0.959, 0.918 and 0.718 for the subdomains of Framework, Project Development, Project Management and Sustainability, respectively. Median domain scores were 0.83, 0.61, 0.76 and 0.75. Median score of the entire tool was 0.67. HPPs operated by the Municipality scored lower than those of non-governmental organizations and health providers/organizations in every domain except for Project Management. Conclusion: A systematic city-wide evaluation of HPPs is feasible and uncovers strengths and weaknesses, including sustainability and variability by programme provider. Academic-community partnerships may assist planning and improving HPPs in the city.