evidence does play a role at key junctures in community change processes. In planning, evidence is used to determine what has worked elsewhere. It improves programs as they are under way, and can be a vital tool for influencing policy change and decision makers. At the same time, however, Solomon stressed the importance of recognizing that different audiences and different kinds of decisions require different levels of evidence.

For instance, community groups find useful many tools that do not adhere to accepted cross-experimental design; an example is PhotoVoice, in which community members document their experience and viewpoints through photography. In contrast, the Congressional Budget Office is debating the kinds of evidence it needs to generate what have been termed “scorable savings” for prevention. As highlighted in the workshop, policy makers draw on different levels of evidence depending on the issue under consideration and the myriad of other issues competing for resources and attention. Solomon urged the IOM, as well as workshop participants, to play a role in determining what constitutes evidence to support change.

“It is really important for us to hold to the fact that different audiences and different kinds of decisions require different levels of evidence.”

—Loel Solomon


This report follows the organization of the workshop. Chapter 5 summarizes the presentations of community-based representatives and the discussion that followed. Chapters 6 and 7 highlight the presentations of nonprofit organizations and policy makers and ensuing discussions, respectively. Chapter 8 summarizes the closing remarks of representatives of two foundations that have supported many community-level programs. It should be noted that consensus recommendations were not sought during the course of the workshop, and thus are not presented in this report.

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