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CATCH: food service program process evaluation in a multicenter trial.

Process evaluation is an essential element of a multicenter trial in order to explain study outcomes and monitor intervention progress. This paper presents the process evaluation model for the Eat Smart School Nutrition Program, the food service intervention component of the Child and Adolescent Trial for Cardiovascular Health (CATCH), and describes the process evaluation strategies developed to assess this program. The paper details (1) measures of program implementation including training, support visits, and program promotion, (2) food service staff characteristics, and (3) measures of mediating variables including secular trends and school meal participation.

Adolescent↗

The reach to recovery program. An evaluation of the attitudes of Connecticut surgeons.

Because the Reach to Recovery Program is under-utilized in Connecticut, the authors sent a 19-part questionnaire to all board-certified general surgeons in the state to evaluate their attitudes toward the Program. Most of the surgeons who responded were pleased with the Program and believed that it saved them time, and was of help to their patients. Twenty percent of the surgeons were unaware of various aspects of the Reach to Recovery Program. Historical and current aspects of the Program are presented. Suggestions are made regarding increasing the scope of the Program to address the needs of women who are to be treated with radiation therapy or who have had a mastectomy and are about to receive adjuvant chemotherapy.

Attitude of Health Personnel↗

The Cleveland Health Quality Choice Program: an evaluation of quality.

The Cleveland Health Quality Choice Program, since early in its inception, has taken advantage of the unique relationship between the purchasers of health care and the providers. Regardless of the outcome of this endeavor, a collaboration has been established between the two and among the medical community involved in this program--a collaboration that the Cleveland community hopes to maintain in the future. Picture it...the business and medical communities sitting down at one table and coming to a consensus on various issues...quite an accomplishment in itself.

Commerce↗

Web-based professional education for advanced practice nursing: a consumer guide for program selection.

As Web-based education becomes increasingly available, there are more educational opportunities to pursue an advanced practice degree. Despite the increasing number of schools delivering Web-based education courses and programs, evaluation of these programs is primarily in beginning stages. The purposes of this article are first to present a scenario of how a Midwestern nursing school developed, implemented, and continually evaluates Web-based education in its master's program, and second to present a consumer guide for program selection. Elements in the guide are derived from program accrediting agencies, the literature, and distance learning experiences. The consumer's guide is presented for nurses interested in exploring or continuing the completion of an advanced practice degree.

Accreditation↗

Cost/effectiveness analysis of alcoholism and drug abuse treatment programs: the relevance of recidivism and resource absorption.

Cost/effectiveness measures are increasingly being applied to alcoholism and drug abuse treatment programs. Program evaluators usually regard readmissions as inadequate for assessing outcome, and resource absorption is rarely examined; this paper presents the argument that increased attention to recidivism and resource absorption is integral to the program evaluation process. Readmissions formed 53% of admissions to U.S. drug abuse programs, and in alcoholism treatment centers, 4% of the patients accounted for 24% of the detoxications. Problems with assessing cost/effectiveness are associated with duration of treatment, average cost, time span of analyses, quasi-experimental designs, multiple episodes of treatment, "silting up", and extrapolation. Five approaches to dealing with these problems are suggested: analyzing existing program data bases for recidivism and resource absorption, considering recidivism when evaluating programs, tempering clinical enthusiasm with skepticism, matching patients with levels of care appropriate to previous treatment history, and assessing additional benefit derived from increasing amounts of care per patient as part of cost/effectiveness analysis.

Alcoholism↗

Evaluation of spouse abuse treatment: description and evaluation of the Air Force Family Advocacy Programs for spouse physical abuse.

Data are reported from a sample of 2,991 spouse physical abusers who received Air Force Family Advocacy Program (FAP) services and who volunteered to complete program evaluation measures that were administered before and after treatment and at a 6-month follow-up. As expected, after treatment compared with before treatment, professionals rated offenders as less at risk, and the offenders indicated general satisfaction with the Family Advocacy Program services. Additionally, as predicted, objective measures indicated that offenders showed significant (p < 0.001) decreases in family conflict and child abuse risk and significant increases (p < 0.001) in family cohesion, family expression, and marital satisfaction. An analysis of the available follow-up data indicated that each of the post-treatment improvements were maintained at the time of the follow-up evaluation.

Adult↗

Towards a faith-based program theory: a reconceptualization of program theory.

A meta-program theory is proposed to overcome the limitations and improve the use of program theory as an approach to faith-based program evaluation. The essentials for understanding religious organizations, their various programs, and faith and spirituality are discussed to support a rationale for developing a faith-based program theory that captures the complex nature of religious program phenomena. Implications for public policy are examined. New concepts based on structural approach and four program theories are formulated for program analysis. Several theoretical concepts for faith-based program evaluation to guide methods for describing patterns that reflect the religious beliefs and values are suggested.

Models, Theoretical↗

A focused strategic plan for outcomes evaluation.

This article describes how organizations devise strategic directions. The process of focused strategic or hoshin planning is introduced and reviewed. This model illustrates how a nursing department planned a focused strategic direction for outcomes evaluation. This discussion includes the dedication of resources, the focusing of research priorities and a summary of the outcomes evaluation program, and the method used for implementation of the priorities. Finally, benefits of both the focused planning process and the outcomes evaluation program are discussed.

Humans↗

A service delivery program and its evaluation. A case study in the sociology of applied research.

Descriptions are rare of instances in which true experimental designs have been implemented in evaluating ongoing programs. This article is a case study of a health service delivery program and the classical pretest-posttest randomized experiment that evaluated it. The main theses are (1) that the research developed was based on the values and interests of the persons and institutions involved, and concordance in interests and values among the several parties was responsible for success in implementing the rigorous experimental design; and (2) that the program being evaluated and the research evaluation affect each other in significant ways, some intended and others unanticipated.

Ambulatory Care↗

Project 12-ways: measuring outcome of a large in-home service for treatment and prevention of child abuse and neglect.

Described here is Project 12-Ways, a large service project employing an ecobehavioral approach to the treatment and prevention of child abuse and neglect. By ecobehavioral it is meant that multifaceted in-home services are provided to clients, and that in-home data are collected on as many variables related to these services as possible. Four levels of research, data collection, and assessment are used to evaluate these services: Included here is a discussion of these levels of assessment. They are: data collected for clinical purposes; data from single-case experiments; research through the use of single-subject design logic applied to several subjects or groups of subjects, or by group statistical research designs; and program evaluation. The particular focus here is the program evaluation data which compare incidents of abuse and neglect during and after treatment between 50 families served by Project 12-Ways and 47 comparison protective service families. The data showed significantly fewer combined abuse and neglect incidents among the families served by Project 12-Ways. Suggestions for additional program evaluation data are provided along with a discussion of the limitations of the current analysis.

Child↗

Evidence-based program requirements: evaluation of statistics as a required course.

A retrospective student record review was conducted to determine how achievement in a prerequisite statistics course related to achievement in nursing research courses and the overall program for undergraduate and graduate nursing students. For undergraduate students (n=218 generic, n=111 RN/BS), the statistics grade was associated with 4.3 percent of the variance in research course grades and 6.8 percent of the variance in graduating grade point average (GPA), controlling for entering GPA. For students in accelerated second-degree programs (n=33), there were minimal differences in mean research course grades and graduating GPA between students with and without prior statistics courses. For master's degree students (n=160), higher statistics grades were not associated with graduate research course grades. At best, the amount of prediction associated with statistics course grades was found to be small and not educationally meaningful. The value of statistics as a program requirement for undergraduate or graduate nursing students cannot be supported by these analyses.

Analysis of Variance↗

Public sector managed care for substance abuse treatment: opportunities for health services research.

Observations of reduced utilization of alcohol and drug abuse treatment following the introduction of managed behavioral health care suggest that substance abuse services may be especially responsive to managed care restrictions and limits. In publicly funded treatment systems, patient attributes, system and provider characteristics, and financing mechanisms may heighten susceptibility to unintended effects. The State Substance Abuse and Mental Health Treatment Managed Care Evaluation Program reviewed state managed care programs for publicly funded alcohol and drug treatment services and is evaluating programs in Arizona, Iowa, Maryland, and Nebraska. The article describes initiatives and outlines evaluation activities. It discusses the opportunities and challenges of assessing public managed care plans.

Arizona↗

The development and evaluation of an interdisciplinary health training program: a pharmacy perspective.

This program integrates training with the clinical interdisciplinary aspects of health care by directly involving pharmacy and other health professional students in an on-going team model of health care delivery. The training program model allows pharmacy students to learn the conceptual basis of team care and to experience directly how this concept is applied in an ambulatory health care setting. Learning strategies include specialty and team delivery of health care, participation in weekly interdisciplinary team training seminars, involvement in problem-solving and other skill building activities, and development of an interdisciplinary team project. Program evaluation results have indicated that students perceive that the interdisciplinary training increased their knowledge and positive attitudes towards interdisciplinary teams. The training also increased their sensitivity to patients, and enhanced the understanding of the problems of delivering health care to an urban community. The results have also shown that through this structured interdisciplinary experience, students reported having a better understanding of the roles of other health professionals and a greater awareness of how these different roles are integrated into a health care team.

Analysis of Variance↗