Date: Tuesday, March 24, 2026
Hello! I’m Valerie Marshall, a Senior Research Associate and doctoral student at Western Michigan University. In this blog, I share findings from a review of the literature on evaluating structural-level health equity interventions, published in six peer-reviewed journals and in grey literature between 2020-2025. These interventions seek to address inequities by targeting systems, such as public policies or social and cultural norms, that drive health disparities.
Of the 205 peer-reviewed and grey literature results, 11 evaluations were included in the final sample. Major findings included the following:
So, what can evaluators learn from this study?
First, findings underscore the importance of documenting context. This allows others to understand how findings may or may not translate to their specific context. Using reporting guidelines, such as those proposed by Montrose-Moorhead and Griffith in their article, Toward the Development of Reporting Standards for Evaluations, can ensure that readers receive comprehensive information.
Secondly, values permeate every aspect of an evaluation, most notably in how success and merit are defined, given the evaluation criteria. Naming values is also a key component of producing quality evaluation, as outlined in the Joint Committee on Standards for Educational Evaluation. Discussing with evaluation interest-holders what success looks like and why, or why the intervention is important and needed, is one way to surface values and beliefs.
Lastly, while only 11 articles and reports were included in the final sample, three did not report using any evaluation-specific methods to visualize and capture change. While this may relate to reporting, it may also reflect a larger gap in the evaluation literature for these interventions, which are often multi-level, complex, and longitudinal. Leading systems change and evaluation practitioners have developed a series of free online videos covering a range of topics to help those evaluating structural-level change, called the Systems Masterclass. It is a great place to learn about useful methods and approaches for this type of initiative.
Lastly, what do these findings mean more broadly for evaluation practice and scholarship?
First, they signal a need to understand and address the gap between individual and structural-level outcomes. What funding, tools, or other resources contribute to this issue? What are the unintended consequences of this gap? Secondly, evaluators may need help in evaluating these types of interventions through evaluation capacity-building efforts or the development of communities of practice. Both are likely important to supporting equity.
The American Evaluation Association is hosting Health Evaluation TIG Week with our colleagues in the Health Evaluation Topical Interest Group. The contributions all this week to AEA365 come from our Health Evaluation TIG members. Do you have questions, concerns, kudos, or content to extend this AEA365 contribution? Please add them in the comments section for this post on the AEA365 webpage so that we may enrich our community of practice. Would you like to submit an AEA365 Tip? Please send a note of interest to AEA365@eval.org. AEA365 is sponsored by the American Evaluation Association and provides a Tip-a-Day by and for evaluators. The views and opinions expressed on the AEA365 blog are solely those of the original authors and other contributors. These views and opinions do not necessarily represent those of the American Evaluation Association, and/or any/all contributors to this site.