Lessons from a mixed-methods approach to evaluating Active Living by Design.

BACKGROUND: Beginning in 2003, Active Living by Design (ALbD) established innovative approaches across 25 communities to increase physical activity through community design, public policies, programming, and communication strategies. PURPOSE: The complexity of the ALbD projects called for a mixed-methods evaluation to understand implementation as well as perceived and actual impacts of these efforts. METHODS: Six primary evaluation methods addressed three primary aims: (1) to assess impacts of physical projects and policy changes on community environments; (2) to document intervention strategies implemented, as well as intended and unintended consequences; and (3) to identify strengths and challenges in planning, developing, and implementing interventions. The ALbD evaluation included cross-site comparisons and more in-depth case studies. This article describes the methods used to address the three aims. RESULTS: Analysis of the strengths and challenges associated with the different methods, including partnership capacity surveys, Concept Mapping, an online progress reporting system, key informant interviews, focus groups, and photos and videos. Additional methods, including environmental audits and direct observation, were explored to specifically assess environmental changes. Several important challenges included the lack of baseline data, difficulty in evaluating natural experiments, the need for ongoing policy surveillance, and the need to capture longer-term endpoints. CONCLUSIONS: The mixed-methods evaluation of ALbD advances implementation and evaluation science related to community-based efforts for promoting active living through identification of methods and measures to capture multicomponent and complex interventions as well as translation of a range of approaches to create community change across a variety of populations and settings.