Year of Publication



Martin School of Public Policy and Administration

Degree Name

Master of Public Administration

Executive Summary

Since 2005, The Council of State Governments (CSG) has participated in a cooperative agreement funded by the Centers for Disease Control and Prevention (CDC) called the Healthy States Initiative. The initiative promotes public health by providing information resources to state legislators through publications and public health forums. CSG is interested in information about the impact of the public health forums on state legislators. More specifically, they would like to know if the forums have encouraged the participants to produce public health legislation, to support funding for public health projects, and to work closely with colleagues and various groups to improve the health of those in their state and communities.

A survey instrument was developed to collect assessments from the participants of the 2006 and 2007 forums regarding follow-up actions. The study population consisted of state legislators who had participated in the forums and were still in office. Differences in responses from those who attended only one forum and those who attended more than one were assessed by using the t-test for the difference between two means. Differences in follow-up actions by the attendees by forum were also examined. Descriptive statistics were used to summarize results from the survey. Qualitative analysis was also used to analyze the open-ended responses for common themes. To improve reliability, a second individual coded open-ended responses to the surveys to insure there was inter-rater agreement.

In each of seven categories of potential follow-up actions, at least 75 percent (and up to 93 percent) of the legislators reported taking action as a result of attending the meetings. The majority of legislators said (for all actions) that the meetings were “important/very important” in encouraging them to take action. About 90 percent said they worked closely with legislators, influenced others to become more active on public health issues, sought more information from state or local public health officials, and worked more with public health organizations. About 75 percent said they supported funding for a public health program covered at a meeting and used information presented at the meetings in speeches, newsletters, or websites. Legislator ratings on the link between the meetings and taking action were highest for “Supporting legislation on a specific public health program covered at Healthy States meeting.”

Although the posttest results are encouraging, I would recommend that a retrospective pretest be developed as the next step for this evaluation. It would provide a greater understanding of the effectiveness of the policy forums. Information about ways to improve the forums would also be gained by comparing the results of the retrospective pretest with the posttest. It would also be worthwhile to ask about the barriers or other priorities that prevented certain follow-up actions by those who responded in the posttest that they did not take such action. This information would also be helpful in improving knowledge transfer when planning future events. An objective analysis could also be conducted comparing health legislation introduced by participants before and after attending Healthy States events with a comparison group of non-attendees. I also recommend that CSG utilize the pretest-posttest design for future assessments of Healthy States events.