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PubMedDate not supplied

The Pyramid Model: an integrated approach for evaluating continuing education programs and outcomes.

Recent mergers and downsizing of health care agencies have made resources for continuing education (CE) increasingly scarce. Nurse educators must demonstrate the effectiveness and sustainability of CE programs and establish the link between nursing professionalism and positive patient outcomes. The Pyramid Evaluation Model expands and enhances previous evaluation frameworks. Simple steps are outlined to evaluate CE programs and outcomes systematically and comprehensively through an impact model that examines goals, reviews program design, monitors program implementation, assesses outcomes and impact, and analyzes efficiency.

Cost-Benefit Analysis↗
PubMed2003

Alzheimer's Caregiver Support Online: lessons learned, initial findings and future directions.

Family caregivers of older adults with progressive dementia (e.g., Alzheimer's disease) are faced with a variety of emotional and behavioral difficulties, such as dealing with persistent, repetitive questions, managing agitation and depression, and monitoring hygiene and self-care activities. Although professional and governmental organizations have called for the creation of community-based education and support programs, most dementia caregivers continue to receive little or no formal instruction in responding effectively to these challenges. The current paper describes the development and implementation of Alzheimer's Caregiver Support Online, a Web- and telephone-based education and support network for caregivers of individuals with progressive dementia. Lessons learned from the first two years of this state-supported initiative are discussed, followed by the findings of a Robert Wood Johnson Foundation-funded strategic marketing initiative and an initial program evaluation of AlzOnline's Positive Caregiving classes. Finally, clinical implications and future directions for program development and evaluation research are proposed.

Aged↗
PubMed1993

Leadership development for medical students--beyond the prescription pad.

BACKGROUND: Physicians are often perceived as leaders in their communities and are expected to participate in politics, business, and volunteer activities. Medical students receive little guidance about becoming effective community leaders. PROGRAM DESCRIPTION: We developed a leadership training program for medical students. Participation in the program was voluntary. The principal forum for this program was a dinner seminar series, which emphasized presentations by current community leaders and identification of leadership opportunities in which medical students could participate. PROGRAM EVALUATION: Information collected at the onset of the program identified the students' concern and priorities regarding leadership activities. Seventy-seven percent of participating students identified good communication skills as the most important quality of a leader. In identifying an issue in which physicians might become involved, students noted only medically related issues, such as access to health care. No long term evaluation data are available to assess the effect of this program. CONCLUSION: Medical school curricula should teach students the leadership skills they will need to participate in community activities.

Community Participation↗
PubMed1999

Psychological conditions diagnosed among veterans seeking Department of Defense Care for Gulf War-related health concerns.

The Comprehensive Clinical Evaluation Program is a US military program that provides a voluntary, clinically oriented evaluation for Gulf War health concerns. This article presents administrative data on psychological conditions (as coded using the International Classification of Diseases, 9th Revision) from the first year of the program. The most commonly diagnosed psychological conditions were medically unexplained physical-symptom syndromes; depression and anxiety, including post-traumatic stress disorder; and alcohol abuse or dependence. Psychological conditions were significantly related to a higher number of workdays lost, and the 19% of veterans with a primary diagnosis of a psychological condition reported 28% of the lost workdays among veteran who participated. Stressful Gulf War experiences were weakly but significantly related to psychological conditions. We conclude that among Gulf War veterans seeking evaluation for Gulf War-related health concerns, psychological conditions are common and are associated with important occupational morbidity.

Adult↗
PubMed1986

Evaluation of fellowship and residency programs in a comprehensive cancer center.

A Dental Oncology residency and fellowship program was evaluated annually from 1980-1984 by each trainee. Nineteen training program variables were assessed on an Exit from Training Questionnaire using 0-100 mm linear scales. The five annual scores for each variable were subjected to trend analysis. Implication of the results to the training program are discussed. The evaluation method may be used to establish a departmental training program benchmark in relation to which future performance can be measured and as a guide to program modification. The method may be applied to all departmental training programs and, when combined, to the institution as a whole.

Cancer Care Facilities↗
PubMed2003

Development and testing of a framework for assessing the effectiveness of health promotion.

OBJECTIVES: The purpose was to develop and test a framework for assessing the overall effectiveness of health promotion in one Canadian province. METHODS: The project relied on expert opinion and consensus. A multidisciplinary team developed a Project Description Framework and a Health Promotion Evaluation Framework. Two sets of inclusion criteria were developed for selecting projects to be assessed using the Framework. The sampling frame was all health promotion projects starting in Alberta in January 1993 or later for which a written program evaluation could be obtained. Of 180 project reports, 91 met the first set and 35 met the remaining inclusion criteria. Two research associates independently used the Project Description Framework. Three associates independently applied the inclusion criteria. Consensus was reached in all cases. Research team members used the Health Promotion Evaluation Framework to assess the 35 projects and to comment on its utility and any gaps identified. RESULTS: A framework for assessing the effectiveness of health promotion was developed and tested. CONCLUSION: This framework is a useful tool as evidenced by the review that was obtained and subsequent applications.

Alberta↗
PubMed2000

Offering HIV prophylaxis to people who have been sexually assaulted: 16 months' experience in a sexual assault service.

The sexual assault service, operated by the Children's & Women's Health Centre of British Columbia in partnership with the Vancouver General Hospital Emergency Department, started offering HIV prophylaxis in November 1996 to patients presenting to the emergency department after a sexual assault. In the first 16 months of the program a total of 258 people were seen by the service, of whom 71 accepted the offer of HIV prophylaxis. Only 29 continued with the drug treatment after receiving the initial 5-day starter pack, and only 8 completed the full 4-week treatment regmen and returned for their final follow-up visit. Patients at highest risk for HIV infection (those who had penetration by an assailant known to be HIV positive or at high risk for HIV infection [men who have sex with men, injection drug users]) were more likely to accept prophylaxis and more likely to complete the treatment than those at lower risk. Compliance and follow-up were the main problems with implementing this service. Service providers found it difficult to give the information about HIV prophylaxis to traumatized patients. After this program evaluation, the service changed its policy to offer HIV prophylaxis only to people at high risk of HIV infection. This targeting of services is expected to make the service providers' jobs easier and to make the program more cost-effective while still protecting sexual assault victims against HIV infection.

Adolescent↗
PubMed1969

Two years of PKU testing in California. The role of the laboratory.

A cooperative phenylketonuria screening program involving private nongovernmental laboratories, individual physicians and local and state health departments has been in operation for two years. The system has evolved to the point where practically all newborns are tested. The accuracy of laboratory work has been verified by an ongoing evaluation program which has resulted in continual improvement in level of performance. There are two areas in which some beneficial changes might be considered. One is the reduction of costs of the testing and follow-up by increasing volume and centralization of work. The other is greater cooperation of the medical community in collecting the data necessary to evaluate the program and expedite the final diagnosis.

California↗
PubMed1995

Preventing restrictive placements through community support services.

A policy evaluation of Community Support Services, an assistance group created by the Minnesota Department of Human Services to prevent admission of individuals with developmental disabilities to large state facilities, was presented. The model of these out-reach services was described. Program evaluation data were presented. The possible effect of Community Support Services on admissions to large state facilities, characteristics of individuals served compared to those waiting for these services, cost-benefit issues of operating Community Support Services, and community service providers' satisfaction with these services were discussed. Issues related to the establishment and operation of Community Support Services were also presented.

Activities of Daily Living↗
PubMed1994

Evaluation of the IMPACT blood pressure program.

To evaluate the incremental effectiveness of a work-site blood pressure control program, we conducted a randomized, controlled trial at four work sites with established health promotion programs. Workers with blood pressures of 140/90 mm Hg or higher were eligible. Eighty subjects were assigned to receive a referral to a community physician, monthly 10-minute work-site counseling sessions including blood pressure readings, and personalized mailings, whereas 79 control subjects received only a physician referral. Results for 74 intervention and 71 control subjects were obtained after 1 year. As compared with control subjects, intervention subjects experienced average declines of 8.5/3.9 mm Hg. Adjusted for age, sex, and baseline blood pressure, the decreases were 7.6 mm Hg for systolic and 2.4 mm Hg for diastolic blood pressure. These results suggest that counseling of high-risk persons and personalized mailing programs can have an incremental benefit in controlling blood pressure.

Counseling↗
PubMedDate not supplied

Preparing psychiatric mental health nurses for the future. A baccalaureate curriculum design.

In the future, nurses can expect to provide holistic care for clients with increasingly complex health concerns. The current shift toward wellness and renewed emphasis on treating the whole person means that nurses must be prepared to meet their clients biopsychosocial health promotion and health restoration needs. The authors outline the efforts of faculty members to create and implement an innovative curriculum design for the psychiatric mental health component in a baccalaureate program. Evaluation data also are included.

Curriculum↗
PubMed1999

Medicaid recipients' experiences under mandatory managed care.

OBJECTIVE: To describe Medicaid recipients' experiences with the outcomes of access, quality, and satisfaction in a mandatory managed care (MC) program. STUDY DESIGN: A qualitative case study design with content analysis of narrative focus group (FG) data, which was part of a comprehensive program evaluation that also involved pre- and postsurveys and analyses of cost and utilization data. PATIENTS AND METHODS: Six FG interviews were conducted in the autumn of 1997 with 31 women on the Aid to Families with Dependent Children program. Participants were recruited from a randomly ordered list of women who had responded to a 1996 premanaged care survey regarding their or their child's healthcare experiences under traditional Medicaid. RESULTS: There was general consensus across all focus groups on a range of issues, including improvements in access to primary care and continuity of care. Overall, few participants expressed discontent with restriction of choice of provider and on MC policies regarding use of the emergency room. There was no consensus on what factors influenced choice of MC plan, although convenience of location was named most frequently. An unanticipated outcome was the recurrent theme across all focus groups of disrespectful treatment by healthcare personnel, especially under traditional Medicaid, which had declined somewhat under managed care. CONCLUSIONS: These contextual accounts identify specific features of a mandatory Medicaid MC program that are viewed as improvements over traditional Medicaid. Specific features that were dissatisfying can be addressed to improve both enrollee satisfaction and the transition to managed care for Medicaid recipients.

Aid to Families with Dependent Children↗
PubMed2001

Evaluation of a program to reduce back pain in nursing personnel.

OBJECTIVE: To evaluate the effectiveness of a program designed to reduce back pain in nursing aides. METHODS: Female nursing aides from a university hospital who had suffered episodes of back pain for at least six months were included in the study. Participants were randomly divided into a control group and an intervention group. The intervention program involved a set of exercises and an educational component stressing the ergonomic aspect, administered twice a week during working hours for four months. All subjects answered a structured questionnaire and the intensity of pain was assessed before and after the program using a visual analogue scale (VAS). Student's t-test or the Wilcoxon Rank Sum Test for independent samples, and Chi-square test or the Exact Fisher test for categorical analysis, were used. The McNemar test and the Wilcoxon matched pairs test were used to compare the periods before and after the program. RESULTS: There was a statistically significant decrease in the frequency of cervical pain in the last two months and in the last seven days in the intervention group. There was also a reduction in cervical pain intensity in the two periods (2 months, 7 days) and lumbar pain intensity in the last 7 days. CONCLUSIONS: The results suggest that a program of regular exercise with an emphasis on ergonomics can reduce musculoskeletal symptoms in nursing personnel.

Adult↗
PubMed1996

Intervention research: GAO experiences.

This paper describes tools of program evaluation that may prove useful in conducting research on occupational health and safety interventions. It presents examples of three studies conducted by the U.S. General Accounting Office that illustrate a variety of techniques for collecting and analyzing data on program interventions, including analysis of extant data, synthesis of results of existing studies, and combining data from administrative files with survey results. At the same time, it stresses the importance and difficulty of constructing an adequate "theory" of how the intervention is expected to affect outcomes, both for guiding data collection and for allowing adequate interpretation of results.

Accidents, Traffic↗
PubMed1998

A pilot study of faculty development for basic science teachers.

PURPOSE: Relatively little research has focused on faculty development methods that assist basic science teachers to improve their instructional skills. This study was designed to assess the effectiveness for basic science faculty of a faculty development seminar series that had been previously shown useful for clinical teachers. METHOD: The Stanford Faculty Development Program's seminars on clinical teaching were adapted for basic science instruction. Eight pathology faculty participated in a series of nine small-group seminars designed to provide teachers with knowledge of a framework for analyzing teaching and identifying areas for improvement, and skill-based training in specific teaching behaviors. Each seminar included (1) brief lectures, (2) review of videotaped reenactments of teaching interactions, (3) role-play exercises with videotape review, and (4) formulation of personal and departmental teaching goals. RESULTS: Program evaluation included multiple measures: participant self-assessment, student ratings of the participants, and blinded ratings of pre- and post-seminar videotapes of participants' classroom teaching. All measures indicated a positive effect of the intervention. CONCLUSION: Faculty development programs have significant potential to enhance basic science instructors' teaching effectiveness.

Adult↗
PubMed2002

Development and assessment of specialized liaison librarian services: clinical vs. basic science in a veterinary medicine setting.

In 1998, the University of Florida Health Science Center Libraries (HSCL) developed and implemented a Liaison Librarian Program, dedicated to providing customized, subject-specific services to the faculty, students, clinicians, researchers, staff, and administrators of the six Health Science Center Colleges (Dentistry, Health Professions, Medicine, Nursing, Pharmacy, and Veterinary Medicine). Subject- and role-specific (clinical vs. basic sciences) liaisons were assigned. This paper describes the HSCL liaison program, exemplified by the liaisons' work with the College of Veterinary Medicine. Preliminary program evaluation, a pilot project developed to discern the needs of the veterinary medicine clientele and facilitate awareness of liaison services, and subsequent re-evaluation of patron awareness and satisfaction are also discussed.

Communication↗
PubMedDate not supplied

Cost-benefit and cost-effectiveness analysis for health promotion programs.

Health promotion programs have been hailed as having great potential to help solve the problem of rapidly increasing health care costs. In order to assess whether health promotion programs are "worth it," some kind of cost-benefit or cost-effectiveness analysis must be included as part of program evaluation. This article provides a basic introduction to the concepts of cost-benefit and cost-effectiveness analysis, compares them, and presents a simple procedure for performing a basic cost-effectiveness analysis. The potential for health promotion programs to impact on the rising costs of medical care is discussed.

Cost-Benefit Analysis↗
PubMed2002

Recommendations for monitoring and evaluating vitamin A programs: outcome indicators.

Monitoring and evaluation are essential components of vitamin A intervention programs. They enable program managers to track progress in achieving their goals. Recommendations for outcome indicators are based on suggestions from the International Vitamin A Consultative Group Meeting (IVACG) workshop in late October 2000 in Annecy, France, followed by a pre-XX IVACG meeting in Hanoi, Vietnam. In areas with detectable xerophthalmia or eye signs, a fall in the prevalence of Bitot's spots to <0.5% and a decrease in night blindness during pregnancy to <5% indicates that vitamin A deficiency (VAD) is no longer a public health problem, although it still may be responsible for excess morbidity and mortality. Pupillary dark adaptation has been proposed as an objective indicator of vitamin A status. A program is considered to have made progress when the mean pupillary threshold improves to better than -1.24 log cd/m(2). For biochemical indices, the shift of mean or median values or the frequency distribution of preschool children with serum retinol concentration below 0.70 micromol (20 microg/dL), lactating mothers with breast milk retinol values below 0.70 micromol (6 microg per g of milk fat) or below 1.05 micromol (8 microg per g of milk fat) are useful to monitor program progress.

Crops, Agricultural↗