Presented at the European Public Health Conference, 2017 (Baker, C. & Courtney, P.). Contemporary theories and models applied in health promotion evaluation lack sensitivity with respect to recognising and accounting for the wider ecological context in which behaviour takes place. This leads to a deficit in knowledge concerning the nature and value of outcomes experienced by people at which programmes are targeted. An evaluation framework was devised to understand and value the changes that occurred as a consequence of physical activity and sport projects implemented via a two-year health promotion programme in the UK. The Social Return on Investment framework provided a means of understand-ing and valuing the wider social changes of the health promotion programme and ensured the outcomes were grounded in the realities of the people who experienced and implemented the programme. This represents an innovative approach that addresses some of the limitations of contemporary health promotion evaluation approaches. Our conceptual framework helps to understand the wider societal impacts of health promotion interventions which are often neglected.

1. Assessing the value of community health programmes using a Social Return on Investment framework
Dr Colin Baker and Professor Paul Courtney
University of Gloucestershire, UK.
Background
 Contemporary theories and models applied in health promotion evalua-
tion lack sensitivity with respect to recognising and accounting for the
wider ecological context in which behaviour takes place. This leads to a
deficit in knowledge concerning the nature and value of outcomes experi-
enced by people at which programmes are targeted.
 An evaluation framework was devised to understand and value the
changes that occurred as a consequence of physical activity and sport
projects implemented via a two-year health promotion programme in the
UK.
Methods
 A Social Return on Investment evaluation framework (Figure 1) was de-
vised using a qualitatively-driven grounded theory approach. Following
the development of a Theory of Change three outcome domains were
identified which articulated the nature and scope of outcomes experi-
enced by beneficiaries of a community health promotion programme.
 Domain A: Community connections & resources. Domain B: Education
and skills. Domain C: Health and Wellbeing.
 A number of salient measureable outcomes (n = 11) were assessed via
pre and post surveys (n = 135) to measure changes over time following
which the potential reach of the activities were estimated for the whole
programme.
 The extent to which outcomes would have happened without the pro-
gramme, and the extent to which observed and anticipated outcomes
could be attributed to the programme, were accounted for via qualitative
data, on-line surveys and secondary data relating to salient metrics on
health, education and community activity.
Objectives
1. To combine Social Return on Investment (SROI) and Grounded Theory
methodologies to advance methods of inquiry within health promotion eval-
uation.
2. To understand the changes that occur as a consequence of community
health promotion projects implemented with sport and physical activity
funding.
Results
 The findings suggested that every £1 invested in the programme returned £7.25 to society in the form of social and economic outcomes across the
three main outcome domains of community connections and resources, education and skills, and health and wellbeing.
 Breaking down the magnitude of benefit according to the three domains revealed the programme produced approximately two thirds of its societal
return in health and well-being, followed by community connections and resources, and then education and skills.
Figure 1: Evaluation framework
D
Conclusion and next steps
 The Social Return on Investment framework provided a means of understand-
ing and valuing the wider social changes of the health promotion programme
and ensured the outcomes were grounded in the realities of the people who
experienced and implemented the programme.
 This represents an innovative approach that addresses some of the limitations
of contemporary health promotion evaluation approaches.
 Our conceptual framework1
helps to understand the wider societal impacts of
health promotion interventions which are often neglected.
 The indicators of change provide a means of assessing self-reported change
in health and wellbeing in community settings, and in turn the value for money
delivered through health promotion programmes.
Contact: Colin Baker cmbaker@glos.ac.uk
Domains Outcome Indicator Value
Change (%)
A. Commu-
nity con-
nections &
resources
Improved access to community resources % stakeholders who feel that community resources are
more accessible; members of clubs / organisations
+37
Greater integration of social, sport and special
interest groups
% organisations and interest groups reporting improved
links with other groups / community
+14
Improved social capital, community ties and
strengthened civic engagement
Reported change in involvement in local events; club
membership and volunteering
+34
B. Educa-
tion & skills
Reduced social isolation Change in feeling lonely; meeting socially; feeling sup-
ported
+20
Improved competence, engagement and pur-
pose
Involvement in local events; club membership and vol-
unteering; (As a proxy for sense of accomplishment;
getting chance to learn new things; doing what is worth-
while)
+34
Improved physical, social and life skills and
training
Skills acquired and developed; feeling more employable +34
C. Health &
Wellbeing
Improved mental health Improvement in mental health; feeling positive; able to
make up mind about things
+17
Safer and more positive environments Feeling safer in the community; feeling more positive
about local area
+3
Improved well-being through development of
cultural, recreational and sports facilities
Increased life satisfaction; improved health and energy,
increased optimism and self-esteem
+15
Improved physical health, improvement in long
term conditions and reduced treatment
Extent to which people: have a long term condition that
limits daily activities; feel in control of their health; per-
ceive their health to be good or very good
+17
Reduced burden on social care services Support from organisations to help them feel in control
of their life; get health advice
+22
Added social value
Outcome domains, outcomes, indicators and changes over time
n Main steps
1 Identify key stake-
holders
2 Map outcomes
3 Measure and value
outcomes
4 Establish impact
5 Calculate SROI
6 Reporting
1
Baker, C. & Courtney, P. (in press). Conceptualising the wider societal outcomes of a community health programme and developing indicators for their measurement. Research for All. ISSN 2399-8121.