Established in 1999, Racial and Ethnic Approaches to Community Health (REACH 2010) is the Centers for Disease Control and Prevention's (CDC's) cornerstone initiative aimed at eliminating disparities in the health status of African Americans, Alaska Natives, American Indians, Asian Americans, Hispanics, and Pacific Islanders. The CDC supports 40 REACH 2010 community coalitions in designing, implementing, and evaluating community-driven strategies to eliminate health disparities in one or more of six priority areas: breast and cervical cancer screening and management, cardiovascular disease, diabetes, HIV/AIDS, immunizations, and infant mortality (1
). Local strategies incorporate community-based participatory approaches designed to reduce risk factors and the prevalence and impact of chronic diseases. Interventions include individual, family, provider, or community activities focused on the prevention, detection, treatment, and management of one or more of the priority areas. In addition to local evaluation plans, the CDC has a national evaluation strategy for cross-site evaluation of grantee programs to identify and assess successful community partnerships and to determine whether local choices of strategies and interventions produced desired changes in health disparities among racial and ethnic groups. The national evaluation plan has two components: process evaluation and outcome evaluation. The process evaluation collects data to gain insights about coalition characteristics and actions that affect the implementation of the local REACH 2010 program (2
). The outcome evaluation uses surveillance data to determine the impact of local interventions that are implemented to reduce health disparities in racial and ethnic groups (3
). In an effort to provide the REACH 2010 grantees with a clear road map of what is ahead, the CDC developed the REACH 2010 logic model to identify anticipated processes and outcomes and assist communities with evaluation.
A program logic model is defined as a picture of how an organization does its work — the theory and assumptions underlying the program (4
). The program logic model links outcomes (both short term and long term) with program activities or processes and the theoretical assumptions and principles of the program (4
). The logic model helps create a shared understanding of the program's goals and methodology, relating activities to projected outcomes (4
). The basic components of a logic model include factors (resources that potentially enable or limit program effectiveness); activities (techniques, tools, events, and actions of the planned program); outputs (the direct results of program activities); outcomes (changes in attitudes, behaviors, knowledge, skills, status, or level of functioning); impacts (organization-level, community-level, or system-level changes) (4
); and relevant external influences (5
). Variations of the logic model have different names, and these variations are all related to program theory (5
). Logic models come in different shapes and sizes and may be a combination of various program logic models (6
This article describes the logic model developed for REACH 2010 that visually depicts the program's theory of change (5
) for addressing health disparities in local communities. The model is theoretically based and includes the conditions being addressed, activities used to address these conditions, and the expected outcomes of the activities (4
). The REACH 2010 logic model is designed to test the effectiveness of multisite community-based programs in improving the health of racial and ethnic populations. The logic model provides communities with a plausible and sensible model of how the program will work to solve identified problems (5
The REACH 2010 logic model illustrates how a coalition could theoretically produce the desired local health disparity reductions and impacts in racial and ethnic groups. It focuses on the logical approaches of a community coalition that organizes to learn the context of, causes of, and solutions for local health disparities and is prepared to take actions to reduce and eliminate the disparities. It also is a tool used to explain and illustrate program concepts and approaches for key stakeholders. As such, it has assisted REACH 2010 communities in identifying, documenting, and evaluating local attributes in the reduction and elimination of community health disparities.