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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↗
PubMed2000

Smokeless tobacco and smoking cessation: a program evaluation.

During the 1998 mid-winter Board of Directors meeting in Tampa, Florida, the leaders of the Society of Otorhinolaryngology-Head and Neck Nurses (SOHN) discussed the vision and mission of SOHN. Part of the vision that emerged was a long-overdue educational program on smoking cessation. SOHN members wanted a self-contained program to use in their clinical practice or in the community that was simple, easy, and comprehensive. In response to this request, a program was developed and presented at the 1999 SOHN Spring Seminar and repeated at the 1999 SOHN Annual Congress. Program participants increased their knowledge on the subject and expressed positive attitudes about utilizing their knowledge as assessed by two novel evaluation tools. This paper discusses the process of tool development and use as well as the detailed responses of the participants. Directions for future training programs and strategies for increasing implementation of smoking cessation programs in otorhinolaryngology (ORL) nursing practice are also discussed.

Head and Neck Neoplasms↗
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↗
PubMed2002

Characteristics of Mexican-American elders with dementia presenting to a community-based memory evaluation program.

OBJECTIVE: To determine sociodemographic characteristics associated with the initial presentation of Mexican-American elders to a community-based memory evaluation clinic. METHODS: Retrospective review of the charts of 89 Mexican Americans presenting consecutively to an outpatient memory evaluation clinic in San Antonio, Texas. PRINCIPAL FINDINGS: Mexican Americans presented for evaluation with more moderate-to-severe cognitive impairment than previously reported. They also tended to have high levels of IADL (83.1%) and gait/balance (52.3%) impairment, as well as high levels of depressive symptoms (63.1%). CONCLUSIONS: Mexican Americans present for initial evaluation for memory decline with moderate-to-severe cognitive decline and significant dementia-associated co-morbidities. In Mexican Americans, caregiver burden, fall risks, depressive symptoms, and need for IADL support should be addressed on the initial visit for memory decline.

Aged↗