Community health initiatives typically involve time-limited funding from foundation or government grants to support their initial activities. But if there are to be lasting improvements in health outcomes, initiative activities must be sustained over a relatively long period of time. Despite the importance of sustaining work begun under health initiatives, there have been few attempts to track sustainability after the period of funding has ended. This article provides a framework for evaluating the legacy of community health initiatives and illustrates its use with the legacy evaluation from The California Wellness Foundation’s Health Improvement Initiative (HII). The HII was largely successful in sustaining its core elements of collaborative partnerships, community-level systems changes, direct services, and population health measurement. The authors discuss differences in evaluation design and data collection between the funded-period and legacy evaluations; these differences may justify a distinct methodological approach.
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