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Postgraduate training in ambulatory pediatrics. Program evaluation.

Ambulatory pediatric, adolescent medicine, and child development fellowship programs listed in the Ambulatory Pediatric Association (APA) newsletter were surveyed to gather information about the programs for prospective fellows, to develop a descriptive summary, and to determine the extent to which programs adhere to APA guidelines. Number and types of positions offered, criteria for admission to programs, program educational objectives and activities, and career choice of graduates were examined for the 73 programs offering 132 fellowship positions in 1976 to 1977. In general, APA guidelines were followed. Programs emphasized patient care experience in contrast to health care administration, research, and teaching.

Ambulatory Care

Program evaluation in the public interest: a new research methodology.

For every social welfare or social control service program there are several parties, each with different interests: patients, clients, staff, management, and sponsors. Evaluation of such a program in the public interest must take the interests of these parties into account. To do so requires an untraditional methodology, that of a second-person, or communal, science, which is not above the conflict of parties and their interests in specifying the variables, staffing the research, balancing considerations of intrusion against those of bias, considering the action implications of the data, sequentially staging the research, or even publishing findings. This all makes evaluation in the public interest a highly political process often unlikely to be logically decisive about intervariable relationships, to yield generalizable results, or even to be completed.

Attitude of Health Personnel

The eastern Cree bush-kit program evaluation; its usefulness.

In 1982 the Cree Board of Health and Social Services of James Bay in northern Quebec created the bush-kit program to provide hunters and trappers with the technical skills to handle medical problems in the bush. A formative evaluation of the program revealed a decrease in calls and in medical evacuations from the bush and high levels of satisfaction among the participants, health professionals and community leaders. However, specific service accessibility problems were identified at the time of the evaluation as indicated by participation rates of only 50% of the targeted hunters and trappers. These findings as well as discussions with bush-kit administrators led to subsequent improvements in the program and an increased participation rate the following year.

Community Health Workers

Program evaluation in sex education: outcome assessment of sexual awareness weekend workshops.

The results of an outcome assessment of a growth-oriented sex education program are reported. The evaluation project attempted to overcome flaws of existing sex education research by explicitly delineating goals and by incorporating both a rigorous experimental control group design and quasiexperimental cohort comparisons. A Sex Questionnaire (covering sexual knowledge, attitudes, and behavior) was administered to the participants of three weekend workshops at the tiem of registration and 1 month later. Overflow resistration for one workshop permitted the random selection of a no-program control group. Results supported inferences of workshop effectiveness in meeting program goals in the areas of attitude and behavior change, but not with regard to increasing sexual knowledge. Implications for development and evaluation of sex education programs are discussed.

Awareness

The British Columbia Mammography Screening Program: evaluation of the first 15 months.

We report our experiences in the first 15 months of a government-funded pilot project begun in 1988 to study the feasibility of rapid throughput, low-cost screening mammography in British Columbia. The primary goals of the project were (1) to determine the unit cost of screening mammography within the context of the program; (2) to design and put into operation a centralized system of data collection, analysis, and quality control to enable calculations of cancer detection rates, biopsy rates, biopsy yield ratios, staging, and other specific cancer characteristics; and (3) to study compliance in the community where the program was offered. A total of 11,824 women had mammography at a unit cost of U.S. $32.66. Computerized analysis revealed that (1) 11% of women had known primary risk factors; (2) findings on mammograms were interpreted as abnormal in 9% of screening examinations; (3) breast cancers were confirmed in 47 (22%) of 211 patients who had biopsies, and 87% of these were stage 0-1. The overall cancer detection rate was four per 1000, with five per 1000 for women who had not had mammography in the preceding 2 years and one per 1000 for women who had had mammography in the past 2 years. The results show that screening mammography can be conducted at low cost. Data collection and analysis and compliance were sufficiently convincing to initiate province-wide expansion.

Adult

The how and why of the ADA's evaluation program for dental therapeutic products.

Since 1930, the Council on Dental Therapeutics of the American Dental Association has been evaluating dental drug products for safety and efficacy through its Acceptance Program. To date, numerous products have been evaluated, and many hundreds have received the council's seal of acceptance. Acceptance criteria are rigorous, and the council relies on expert consultants to evaluate the supporting data. There are no manufacturer fees involved with the Acceptance Program. When a product has been awarded the seal, it means that adequate data have been submitted, and that the product is safe and does what it says it will do. This paper describes, in detail, how the Acceptance Program works.

American Dental Association

A colorectal cancer prevention, screening, and evaluation program in community black churches.

Colorectal cancer incidence and related mortality are significantly higher in blacks than in whites. The black church has been identified as a means of promoting health issues and intervention programs. The purpose of this study was to implement and evaluate a colorectal cancer prevention and screening program in community black churches. A total of 1,488 Coloscreen III kits were distributed, and a telephone survey was conducted to examine the demographic profile, attitudes, and behaviors of those who returned the kit (17.5 percent) compared with those who did not (82.5 percent). The survey revealed that the majority of both returners and nonreturners felt that the test could detect bowel cancer and that early detection could result in cure. The returners were significantly older and less likely to smoke. The low response was attributed primarily to the test's dietary requirements. Both groups reportedly made changes in their lifestyles as a result of the educational component of the program--that is, they increased their fiber intake and decreased their fat intake, alcohol consumption, and smoking. Even with the low response of this study, educational benefits were evident. If colorectal cancer screening programs in community black churches are to be effective, however, diet-related issues must be addressed.

Black or African American

The university hospital nurse extender model. Part III, Program evaluation.

This article is the third part of a four-part series on The University Hospital Nurse Extender Model Using Patient Care Technicians. Part I provided the overview and conceptual framework for the model. Part II described each phase of the implementation process. This article presents the results of a 1-year evaluation of the impact of the model on nursing practice and satisfaction, and the cost of using the model. Part IV will present the lessons learned from this attempt to reconfigure patient care delivery.

Cost-Benefit Analysis