The success of an effort as expansive as the Healthy South Carolina Initiative (HSCI) can only be assessed through a rigorous process of evaluation. Each project has defined objectives and measurable outcomes that are monitored annually. The overall benefits of this Initiative are expected to go beyond the specific goals of 28 component projects and include enriching the skills of faculty and students, learning more about the populations we serve, fostering collaborative ventures, and improving the lives of the citizens of our communities.

Individual Project Evaluations

Project directors (principle investigators) report annually to the HSCI Advisory Board on their progress in attaining their objectives. They describe any difficulties encountered and their efforts to overcome obstacles. Plans for the upcoming year's activities to accomplish project goals are outlined including detailed justification for any modifications from the original plans.

The project directors track the number of MUSC students and faculty and community partners in various categories for their annual reports. Numbers of persons involved in the projects for four years are impressive. Over 250,000 individuals have been touched by the HSCI projects.

The reports describe their success in sustaining the projects beyond their HSCI funding. Principle investigators have published articles in peer reviewed journals or presented papers at professional conferences describing their work which helps get the attention of other funding agencies like private foundations. Twenty-one of the 28 projects were sustained beyond the funding period. Some of the projects are sustained through integrating them into other programs, and others are sustained through direct payment for services. Nineteen projects have already succeeded in obtaining additional grant funding to extend their projects beyond their initial specific aims, either to another audience or for a longer period of time.

The HSCI Advisory Board, along with the director and assistant director, review each annual report. Letters from the director summarizing the reviews go to each principal investigator, providing feedback and making suggestions for revisions and sustaining the projects.

Overall Initiative Evaluation and Monitoring

The overall evaluation and monitoring process corresponds to the originally stated goals of the HSCI:

Encourage faculty to conduct community-based projects that target priority health issues. Foster cooperation among campus units: colleges, departments, faculty, students. Encourage collaboration between faculty and students of MUSC and other universities and community agencies. Support community projects that will be implemented as planned and be self-sustaining (institutionalized). This includes not only activities on behalf of the community but also cooperation/collaboration efforts. Increase the number of future extramural, community-based projects. Foster changes in delivery systems and policies that improve access and utilization. Improve population outcomes including health status and satisfaction. Encourage the development of cost-effective programs.

Following the first and third years of funding, a process evaluation focused on the collaborative aspects of the projects. Structured interviews were conducted with all the principal investigators and a random selection of partners. In the judgment of most respondents, the projects were highly collaborative.

Twelve specific strategies were identified from the University Strategic Plan that are tied to activities of the 28 HSCI projects. All projects have reported activities in at least some of the strategic categories.

Examples include:

Nineteen projects increased extramural funding. All projects provided improved public access to health education and information, as evidenced by the 250,000 persons exposed to one more HSCI health messages. Seven projects provided interdisciplinary experiences for students from two or more MUSC colleges, e.g., Enterprise/MUSC Neighborhood Health Program, which has involved 373 students from five MUSC colleges, and Integrated Care for Women and Children, which have involved more than 142 students from MUSC colleges. Service-learning has been offered to dental students through the Dental Mobile Van and Dental Outreach to the Underserved.

As part of the Initiative, quarterly programs are presented for faculty development. During the first three years of the Initiative, outside speakers on collaboration, evaluation, service learning, and grant writing were balanced with presentations from the principal investigators on their projects. These sessions were also evaluated by the principle investigators, project staff, and community partners who attended.

Monitoring and evaluation of the 28 projects and the overall Initiative continue following the third year of funding, when most of the projects will have been completed. In addition to the final annual reports from each principle investigator, other interviews will be conducted to elicit information about the overall process, again focusing on collaboration and on student involvement. A series of publications will present elements necessary for success and lessons learned from this endeavor.