Evaluating a complex community initiative like Well London is always going to be a challenge. A What Works Centre for Well-being would, Alison Pearce argues, help organisations to network and share information – getting evidence out of the literature and on to the front line.
Well London is working to improve the health of some of the city’s most disadvantaged communities. How? We’re developing what we believe is one of the most ambitious attempts to apply an asset-based community-led model of health improvement across a world city. This approach harnesses the skills, knowledge and potential of communities and makes them active participants in promoting good health and well-being.
A What Works Centre would help network organisations and promote useful evidence
We’re excited about the potential of a What Works Centre for Well-being to highlight and help with some of the issues we’ve been grappling with when evaluating Well London. Led by the University of East London, we’ve put evidence at the heart of our mission. Through rigorous evaluation we are developing a robust evidence base that will influence policy and practice in London and beyond. Our challenge: how to evaluate complex community-level initiatives like Well London which involve multiple themes and projects. The What Works Centre for Well-being will help us network with other organisations, sharing our research and, importantly, promote useful evidence. Getting it out of the literature and on to the frontline.
Like the evidence we gathered during the assessment of phase one of Well London.
We took a multilevel approach to evaluation looking at the impact at four levels: participant, project, programme and the wider population. Our tools included a randomised controlled trial (RCT) that compared population-level impact in target and matched areas. You can read about our learning here but a What Works Centre would help circulate this evidence more widely than we could ever hope to – maximising its impact.
Our evidence: what we’ve learnt and what we’d like to share
We’re building on this learning now, in the second phase of Well London’s development. Using a longitudinal cohort study, we’re taking a detailed look at impact and pathways for participants. We’ve evolved our approach and are now collecting more systematic information that will allow us to understand our wider impact and legacy including levels of volunteering, uptake of training and pathways to employment.
Evaluation of our experience has shown us:
- Unlike medical interventions and clinical trials, there is no established long-term development pathway for complex community-level interventions like Well London, and far less funding is available. The What Works Centre could promote longer-term approaches to building the evidence on well-being.
- There are many practical challenges involved in delivering the evaluation. They range from high levels of population movement in and out of target areas (‘churn’); the understandable reluctance of many participants to complete a long on-line survey form – compounded by poor English skills and limited access to IT; the need to get buy-in from delivery organisations to systematically register participants. Dealing with these requires time, resources, and recruitment of a high number of volunteer fieldworkers.
- How to communicate our evidence in a way that avoids misinterpretation of the complex results that RCTs can yield?
- How to live our values and make our evaluations more participatory without creating the potential for bias?
As UEL notes “As well as shaping further development of the Well London framework, its evaluations are of wider significance, feeding into discussions of how complex community and social interventions can be developed and evaluated”. A What Works Centre of Well-being would help us share this evidence and advance the conversation.
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Alison Pearce is the Well London Programme Manager based at the Greater London Authority
Views expressed are the author’s own and do not necessarily represent those of the Alliance for Useful Evidence. To learn more about the Alliance and join us (it’s free and open to all) click here.