Research & Evaluation

Our Strategy for Impact:

COPE is a small team aiming for disproportionate impact. Our mission statement anchors us in three notions:

"Our vision is to eliminate health disparities and improve the
well-being of American Indians and Alaska Natives"

We define impact as measurable improvements in health and
well-being

"The power to overturn long-standing, historical health inequalities lies inherently in Native communities themselves"

Community members are our strategic planning, implementation, and evaluation partners"

"We seek to catalyze this transformation within our lifetime"

We are not satisfied with small, incremental change. Unlike other CBOs, we focus less on direct service and more on catalyzing innovation and collaboration among local experts. We support the design and implementation o f these models, and leverage academic and global partnerships to generate evidence and scale proven models for maximum impact.

Evaluation Approach:

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Core outcomes. Across all of our programs, we strive to measure outcomes that are meaningful to at least one of the following areas: health, wellbeing, and self-reliance.

 

Community involvement in impact evaluation: Community members are advisors, co-investigators, data collectors, and co-authors / co-presenters to:

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  • Choose outcomes that are meaningful to our partners

  • Give feedback on surveys and interview guides

  • Interpret data from a community / patient perspective

  • Take part in data collection, analysis and dissemination

  • Ensure we share back results in a meaningful way
     

Rigorous methods: We apply rigorous methods while protecting the programmatic nature of our work. Our evaluation and research team has an established track-record of competitive research funding and draws from both indigenous and Western methodologies.
 

Track-record: It is important to mention that not all innovations will not demonstrate impact; selecting impactful programs and iteratively addressing remaining gaps will ultimately create a holistic approach of inter-related program with the greatest long-term impact. Here is the highlight of finding / publications to date.

  • Significant improvements in blood sugar and cholesterol levels

  • Greater utilization of primary care, behavioral health, and pharmacy services

  • Stronger patient self-reliance

  • Deeper collaboration and work satisfaction among clinic providers and CHRs

Diabetes Outreach:

Integrate CHRs with provider team and deliver structured health promotion to individuals living with diabetes

Fruit and Vegetable Prescription (FVRx) Program

  • Significant decreases in body mass index among children initially enrolled as overweight or obese;

  • Significant increases in fruit and vegetable consumption among women with diabetes in pregnancy and preschool children

Healthy Navajo Stores Initiative (HNSI):

COPE's HNSI team provides structural TA to store on Navajo Nation to increase their supply and promotion of fruits, vegetables and traditional foods

  • A significant increase in fruit and vegetable promotion;

  • A significant increase in purchasing of fruits and vegetables by local shoppers

Scaling for Impact:

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Strategy for scale includes:

Adaptable Models:

Evidence-based models are synthesized as toolkits that can be readily adapted with TA to other communities. We recognize that the context and culture of each Native community is deeply unique. The role of supportive “TA accompaniment” and flexible models is key: adaptation and expansion is a process of bidirectional learning in which the TA team exchanges wisdom with local partners to adapt programs, retaining core elements of the model while allowing flexibility to match the local context.

Training-of-the-Trainer (TOT) approach.

Evidence-based models are synthesized as toolkits that can be readily adapted with TA to other communities. We recognize that the context and culture of each Native community is deeply unique. The role of supportive “TA accompaniment” and flexible models is key: adaptation and expansion is a process of bidirectional learning in which the TA team exchanges wisdom with local partners to adapt programs, retaining core elements of the model while allowing flexibility to match the local context.

Relationships and Technology:

Forming trusting relationships on-the-ground is the first step to any adaptation effort. We are committed to taking the time to learn from our partners and also invite them to see how programs work when already operating. We are also committed to using technology to amplify our reach and streamline processes for maximum efficiency.

Integrating Community Health Representatives with Health Care Systems; Clinical Outcomes Among Individuals with Diabetes in Navajo Nation

published 11/27/2019

Healthy Stores Initiative Associated with Produce Purchasing on Navajo Nation

published 11/7/2019

Cultural Elements Underlying the Community Health Representative - Client Relationship on Navajo Nation

Strengthening the Role of Community Health Representatives in the Navajo Nation

Glycemic Control and Healthcare Utilization following Pregnancy among Women with Pre-existing Diabetes in Navajo Nation

Community Outreach and Patient Empowerment: A Collaborative Initiative for Chronic Disease Management in Navajo Nation

Primary Care and Survival among American Indian Patients with Diabetes in the Southwest United States: Evaluation of a Cohort Study at Gallup Indian Medical Center, 2009-2016

The efforts described on this page are supported by grants to COPE 501(c)3 and grants to our partner organizations, Brigham and Women's Hospital and Partners In Health.