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PubMed1979

Community support programs: program evaluation and public policy.

The plight of chronic psychiatric patients in the community has led to a major federal effort to resolve fragmented and disorganized care. The Community Support Programs (CSPs) recently funded by NIMH offer the promise of reducing these difficulties by creating comprehensive human service systems at the local and state levels. However, the author points out that these demonstration projects should be evaluated lest they continue to operate on the basis of rhetoric rather than fact. He presents an evaluation framework whereby indexes pertinent to each program goal of the CSPs can be measured and the resulting data used for public policy purposes.

Community Mental Health Services↗
PubMed1984

The impact of a psychosocial support program on survival with breast cancer: the importance of selection bias in program evaluation.

A retrospective follow-up study was conducted to assess the impact of a psychosocial support program on survival with breast cancer. One-hundred and two nonparticipants were individually matched to 34 participants on several prognostic factors, and both groups were followed from date of cancer diagnosis (1971-1980) until December, 1981. Preliminary findings suggest a strong beneficial effect of the program on survival, which is statistically significant. However, this observed effect is due largely to a selection bias caused by the failure to match on the duration of the lag period between cancer diagnosis and program entry. Correcting for this bias in the analysis results in a small, nonsignificant program effect. We are not able to rule out a possible effect, however, because of the relative lack of statistical power and because of a modest, though nonsignificant benefit observed for women who entered the program shortly after diagnosis. Furthermore, the program might have other beneficial effects on the quality of life.

Adult↗
PubMed1983

Who volunteers for a breast self-examination program? Evaluating the bases for self-selection.

Interest in a free breast self-examination (BSE) teaching program offered to a patient population (n = 1590) was assessed, and a follow-up survey of refusers undertaken to determine difference between participants and refusers. Fifty-one percent of the known, eligible women patients expressed interest in the program and 24% ultimately had the teaching. Participants differed from refusers most notably in terms of less previous experience with BSE, more family history of cancer, a longer relationship with their physicians, and different health beliefs. They state more confidence in the effectiveness of breast cancer detection and treatment, less fear and embarrassment, and more personal and physician responsibility for health outcomes, as measured by the Health Locus of Control Scales. Self-selection thus seems rationally based on the kind of program and the needs of the women. Such self-selection can be cost-effective in delivering health education to the people most in need of it and most likely to benefit from it.

Adolescent↗
PubMed1988

Undergraduate allied health leadership development: a program evaluation and follow-up study.

The present study reports the 15-year experience of an undergraduate program in preparing allied health professionals for educational leadership positions. Seventy-three professionals completed the BS degree as of August 1986. A substantial percentage of the graduates were attracted to faculty positions in institutions of higher education; 34% had achieved positions of department chair or the equivalent. Over 50% had completed some form of graduate study. The diversified settings and job titles reported indicate that the curriculum possesses validity for a variety of health care educational and administrative positions. Overall, this undergraduate program appears to contribute to the development of leadership personnel in allied health, particularly for those professions that provide entry-level health credentials at the level of associate degree or the equivalent.

Allied Health Personnel↗
PubMed1986

Program evaluation of physical medicine and rehabilitation departments using self-report Barthel.

The Barthel Index measures performance of personal care (feeding, dressing, hygiene) and mobility (transferring, walking/wheeling) activities. Since its inception, several revisions of this index have increased its accuracy in measuring functional ability of patients during medical rehabilitation. However, this activities of daily living (ADL) scale is rarely used to determine the abilities of individuals after discharge, leaving assessment of functional outcome incomplete. In this study this index has been converted to a self-report format, which can be completed easily by the patient or family member both during the rehabilitation stay and after discharge. The reliability of the self-report version is examined, by comparing the assessments of patients to those made by the health professionals. A sample of persons at an inpatient rehabilitation facility, who could both read and write, completed the self-report during the week before discharge. Results comparing the assessment of professionals and patients showed a statistically significant difference with p less than 0.001. This paper will suggest reasons for the difference and explore the possibility of using this self-report version as a means to evaluate both the short-and long-term outcomes of rehabilitation programs.

Activities of Daily Living↗
PubMed1987

Survival analysis in drug program evaluation. Part II. Partitioning treatment effects.

Survivorship analysis is applied to both a summative process (during treatment) and a summative outcome (after discharge) evaluation comparing data obtained from 297 admissions to multiple-site methadone maintenance programs in three California counties. Measures included rates of retention, incarceration, addiction, crime, dealing, and loss of employment. In order to take full advantage of the multiple outcome measures that were used, a method for within-subject simultaneous consideration of all outcome measures is presented. This method is an adaptation of the Friedman nonparametric analysis of variance and a Bonferroni post hoc comparison of the mean ranks.

Crime↗
PubMed1975

[The Caceres-USPHS (version HP-3) computer program. Evaluation of automatic analysis of 40,000 ECG (author's transl)].

The main features of Caceres-USPHS (version HP-3) program for automatic analysis of the ECG are reviewed. Our experience at the Ospedale Regionale di Udine has now reached a total of 40,000 tracings analyzed by such a program and with an HP 1530-A computer system. In a detailed study of 1,000 consecutive computer-analyzed tracings reviewed by three experienced cardiologists, 534 were normal and 466 abnormal. A high degree of specificity was detected in the normal group (only 1.5% of false negatives) while the sensivity was rather low. In the abnormal group there were 18.1% of false positives and while the agreement was 100% in complete bundle branch block and some types of infarction, it was 56% in atrial fibrillation and 47% in incomplete right bundle branch block. Program errors were more common in measurements and pattern recognition; they were unusual in the program logic (0.3%). A significant improvement over comparable data obtained one year previously was attributed to a better quality control in data recording and to increase physician acceptance of the program diagnostic criteria. On the current and past figures of accuracy, it is concluded that the version HP-3 of Caceres-USPHS program represents a step forward in computer-derived ECG interpretation. However more progress is still needed for a larger and more profitable clinical application of this ECG computer program.

Computers↗
PubMed1989

Supported employment program evaluation: evaluating degree of implementation and selected outcomes.

The relation between the degree to which adult service agencies implemented supported employment and selected program outcomes was examined. Supported employment programs developed by adult vocational service agencies in Illinois served as the subject pool for data collection. Results indicated that clients with higher IQs received less complete support services but earned higher wages. Vocational service agencies that spent more time developing jobs seemed better at matching job requirements with clients' skills.

Employment↗
PubMed1995

Recruitment to a university alcohol program: evaluation of social marketing theory and stepped approach model.

BACKGROUND: This study was a first initiative to evaluate the application of social marketing theory (SMT) to increase attendance at an alcohol abuse education program for university residence hall students and to ascertain whether aggressive recruitment strategies are necessary as part of the stepped approach model (SAM) of service delivery. METHOD: SMT and public health strategies that include focus groups, in-depth interviews, and intercept interviews were used to develop recruitment materials in a Test Hall. These new recruitment materials were introduced to the residents in the Treatment Hall (N = 727) and were compared to the Usual Care, Control Hall (N = 706) which received the recruitment materials normally provided to residents as well as to three Historical Halls separately and combined which had used the Usual Care recruitment materials in the past. RESULTS: The Treatment Hall percentage attendance was significantly superior (0.001 < p < 0.05) in all comparisons. The percentage attendance did not differ significantly from marketing literature expectations. The projections for campus-wide attendance for residence hall students were between 207 and 243 participants and for nationwide attendance, 36,900 +/- 8,185. CONCLUSIONS: The results suggest that the SMT and public health methods used are helpful in developing recruitment strategies and are an important initial step of the SAM and that a "minimal intervention" recruitment strategy is a cost-effective approach that can have a dramatic impact.

Adolescent↗