Sustainable community health improvement often requires the implementation of complex interventions in complex systems. Drawing from the "Four Keys to Success" frame (theory, implementation, support, and evaluation), this article describes how we used a formative evaluation approach to foster a learning system capable of monitoring and…

In a complex, multisite initiative, a well-developed theory of change can help an organization's leadership make strategic decisions about program elements, organizational direction and priorities, as well as provide structure and accountability for evaluation. This article describes the multistep process used by the evaluation team of a large…