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PubMed2002

Integrating quantitative and qualitative methods to assess the impact of child survival programs in developing countries: the case of a program evaluation in Ceara, Northeast Brazil.

In evaluating public health programs, the tradition has been to design quantitative approaches, relying on epidemiological and statistical techniques to determine if and to what extent a program has an effect on a predetermined targeted population. More recently, however, qualitative methods such as rapid ethnographic assessments and focus groups have been implemented more frequently. This article describes an outcome evaluation of a community health workers program that integrated quantitative and qualitative methods to assess the impact of child survival interventions in reducing infant mortality and inadequate weight gain in children among municipalities in the state of Ceara, Northeast Brazil. By using multiple methods that combine quantitative and qualitative components, researchers can broaden their understanding of complex public health issues and direct use of data for decision making.

Adult↗
PubMed1990

Attendance at health promotion programs: baseline predictors and program outcomes.

As part of a family cardiovascular health promotion project, 111 Mexican-American and 95 Anglo-American families with fifth- or sixth-grade children were assigned to either a primary prevention program involving 18 sessions or to a control condition. This article evaluates predictors of attendance at the year long sequence of sessions in the intervention group. In addition it considers the relationship between attendance and program outcomes. Low baseline scores on physical activity and cardiovascular fitness measures were associated with higher attendance for both children and adults. High initial health knowledge and self-motivation were also associated with attendance. Multiple regression analysis showed that adult attendance was significantly predicted by a model including completion of a three-day food record, low exercise, higher socioeconomic status, family adaptability, and self-motivation. Attendance was correlated with greater knowledge gains and larger reductions in blood pressure. The results indicate that motivated families who are in greater need of conditioning attended more sessions in a health promotion program.

Adult↗
PubMed2002

Comparing an IPM pilot program to a traditional cover spray program in commercial landscapes.

An integrated pest management (IPM) pilot program for landscape plants was implemented during 1997 and 1998 on two commercial, two residential, and one institutional property managed by landscape professionals. When compared with preprogram, calendar-based cover spray program costs at these sites in 1996, the IPM program was cost-effective at one of the five sites in both 1997 and 1998, and cost effective at a second additional site in 1998 when the cooperator, initially skeptical of IPM, discontinued calendar-based cover sprays performed in 1996 and 1997. The mean cost per site was $703.40 (preprogram), $788.26, and $582.22 in 1996, 1997, and 1998, respectively. Volume of pesticide applied decreased a mean of 86.3% on the four sites not receiving cover sprays and increased 2.3% at site 2 (still using cover sprays) in 1997. In 1998, pesticide volume was reduced an average of 85.3% at all five sites compared with preprogram levels. The majority of insect pest problems were corrected using spot sprays of insecticidal soap or horticultural oil or by physical means such as pruning. One-third of the woody plant material on the commercial and institutional sites consisted of holly, juniper, and azalea. The most prevalent pests encountered were mites (Tetranychidae), aphids, lace bugs, scales, whiteflies, and Japanese beetle. Spiders were the most abundant group of predatory arthropod and ants, green lacewings, and lady beetles were also well represented in the managed landscapes.

Animals↗
PubMed1979

Program evaluation research: an experimental cost-effectiveness analysis of an armed robbery intervention program.

An armed robbery alarm system was implemented in 48 different stores in two separate geographical areas for 6 months and 12 months, respectively. The alarms were placed in the two separate areas at different times and all alarms were eventually removed. Thus, multiple baseline and reversal strategies were used to evaluate program impact. A device planted in a cash drawer was triggered whenever "bait" money was removed from the drawer sending an alarm signal directly to police cars and headquarters. On-scene apprehensions of armed robbers within target stores were greatly increased even though the armed robbery systems did not deter robbery incidents nor influence the court disposition of the cases. There was also no crime deterrence, crime displacement, or increased apprehensions in either the immediate neighborhoods of target stores or on a city-wide basis. The cost effectiveness of the program was calculated to be poor even though the program is being maintained because of the absence of an alternative robbery apprehension technology.

Cost-Benefit Analysis↗
PubMed2000

Factors predicting completion of a home visitation program by high-risk pregnant women: the North Carolina Maternal Outreach Worker Program.

OBJECTIVES: This study sought to identify characteristics of high-risk pregnant women that predicted long-term participation in a home visitation program. METHODS: Data regarding sociodemographic characteristics, perceived needs, psychological functioning, substance use, and informal social support were collected prospectively from 152 short-term and 221 long-term program participants. RESULTS: In comparison with short-term participants, long-term participants were more likely to have been African American, married, nonsmokers, and enrolled in the program during their second trimester of pregnancy, and they were more likely to have had emotional and instrumental support needs. CONCLUSIONS: Women with greater social support needs and healthier behaviors were more receptive to long-term home visitation than other women.

Adolescent↗
PubMed1988

Differences in psychological need hierarchy between program completers and dropouts from a drug abuse treatment program.

Psychological need patterns among 116 drug addicts in treatment were measured with the Adjective Checklist. Compared to program completers, program dropouts had higher needs for autonomy and aggression and lower needs for deference, nurturance, and affiliation. This personality style may form the basis of dropping out, among certain types of addicts in certain types of programs, when faced with situational, environmental, or interactional stress. Results also suggest that we may be able to identify a personality pattern at risk for premature termination before the person experiences the impulse to leave.

Adult↗
PubMedDate not supplied

The relationship between the quality of drug user treatment and program completion: understanding the perceptions of women in a prison-based program.

To determine why some women offenders complete prison-based drug user treatment and others leave early, clients' (N = 101) perceptions of various aspects of the quality of the treatment experience were compared. Analyses of both quantitative and qualitative data indicate that clients who completed the program had a more favorable perception of staff and felt empowered by the experience in treatment. Most of the clients who left early did so because of conflicts or disagreements with the program's rules. We discuss how a supportive approach to personal development may enhance client perceptions of program quality and increase retention rates.

Adult↗
PubMed1988

A comparison of motor performance of preschoolers enrolled in mental health programs and non-mental health programs.

Recognizing that the etiologies of some major mental illnesses may be in the physical domain, this study described and compared the motor performance of 27 preschool children enrolled in mental health programs with 27 children enrolled in Project Head Start, a non-mental health program. The two groups were matched for age, race, and sex. The Gross and Fine Motor scales of the Peabody Developmental Motor Scales were administered to all subjects. On both measures the children enrolled in mental health programs scored significantly lower than the children enrolled in Project Head Start. In addition their scores were more variable. The results of this study support other findings suggesting that developmental delays may be characteristic of children with emotional disturbances.

Child, Preschool↗
PubMed1990

Medicaid program; Medicaid eligibility quality control (MEQC) program requirements--HCFA. Final rule with comment period.

This rule revises the regulations governing the Medicaid eligibility quality control (MEQC) program to include more specific program requirements and to establish new timeframes for completing and reporting MEQC case findings to HCFA. The rule also establishes a performance-based threshold for States to meet before HCFA will consider good faith waiver requests of disallowance of Federal financial participation (FEP) in erroneous Medicaid payments and provides more definitive criteria for evaluating States' good faith efforts to meet the national standard error rate. In addition, the rule makes several technical changes and provides that a State may rebut its projected error rate only when it can present evidence that its projected error rate was based on erroneous data. These revisions will strengthen the basic MEQC program and provide flexibility and incentives to States to produce accurate Medicaid eligibility determinations.

Centers for Medicare and Medicaid Services, U.S.↗
PubMed1991

Medicaid program: Medicaid eligibility quality control program--HCFA. Response to comments on final rule.

This document responds to public comments received by the Department on a final rule issued on May 31, 1990, relating to the Department's decision not to publish regulations on the basis of the results of congressionally mandated studies of the quality control systems for the Aid to Families with Dependent Children (AFDC) program and the Medicaid program. The purpose of the studies, which were required by the Consolidated Omnibus Budget Reconciliation Act of 1985, was to examine how best to operate quality control systems in order to obtain information which would allow program managers to improve the quality of administration and provide reasonable data on which to base withholding Federal matching payments for excessive levels of erroneous State payments.

Centers for Medicare and Medicaid Services, U.S.↗
PubMed1992

Medicare program; recognition of the Community Health Accreditation Program standards for home care organizations--HCFA. Final notice.

This final notice recognizes accreditation by the Community Health Accreditation Program (CHAP), a subsidiary of the National League for Nursing (NLN), for home health agencies (HHAs) that wish to participate in the Medicare Program. As a result of this recognition, HHAs accredited by CHAP are deemed to meet the Medicare conditions of participation for HHAs to the extent described in this notice. This final notice sets forth certain specific requirements with which CHAP must comply to maintain Medicare recognition of its HHA accreditation program.

Accreditation↗
PubMed1992

LPTP's (Laboratory Proficiency Testing Program) educational assistance program (EAP)--a review.

The Educational Assistance Program (EAP) of the Laboratory Proficiency Testing Program (LPTP) in Ontario, Canada, provides at-the-bench in-service education to the technological staff in smaller, remote or rural hospital laboratories. This service is provided to laboratories which have either been identified by LPTP as experiencing problems or on direct request. The tutorials are conducted by experienced volunteer technologists. LPTP carries out mandatory testing and proficiency evaluation in Ontario. Funded by the Ministry of Health of Ontario, EAP is offered voluntarily and without charge as part of LPTP's educational component of external quality assessment. Preliminary post-tutorial proficiency testing results show improved performance and recipient evaluation forms express an enthusiastic response. Both support continuation of this unique program.

Clinical Competence↗
PubMed1993

Medicare and state health care programs: fraud and abuse; amendments to OIG exclusion and CMP authorities resulting from the Medicare and Medicaid Patient and Program Protection Act--Office of Inspector General (OIG), HHS. Final rule.

This document amends a technical error that appeared in the final rule, which amends the OIG exclusion and CMP authorities, published on January 29, 1992 designed to implement section 2 of the Medicare and Medicaid Patient and Program Protection Act, along with other conforming amendments. The final rule is designed to protect program beneficiaries from unfit health care practitioners, and otherwise improve the anti-fraud provisions of the Department's Medicare and State health care programs.

Fraud↗
PubMed1993

Civilian Health and Medical Program of the Uniformed Services (CHAMPUS); specialized treatment services; nonavailability statements; peer review organization program; supplemental care--DoD. Final rule.

This final rule: establishes a Specialized Treatment Services Program, under which CHAMPUS beneficiaries in need of certain highly specialized medical care will be referred to specially designated national or regional, military or civilian treatment facilities; revises a number of procedures applicable to the CHAMPUS Peer Review Organization program; and expands reliance on CHAMPUS payment rules and procedures for purposes of the supplemental care program, which applies to services provided by civilian providers to active duty members and certain other patients referred by military providers.

Economics, Medical↗
PubMed1994

Child support enforcement program: paternity establishment and revision of child support enforcement program and audit regulations--Office of Child Support Enforcement. Final rule.

This final rule contains provisions regarding both paternity establishment and the audit. The paternity establishment provisions implement the requirements of section 13721 of the Omnibus Budget Reconciliation Act of 1993 (OBRA '93) signed by the President on August 10, 1993, which amends title IV-D of the Social Security Act (the Act). These provisions require States to adopt procedures for a simple civil process for the voluntary acknowledgement of paternity, including early paternity establishment programs in hospitals. For paternity cases that remain contested, the statutory provisions require States to adopt a variety of procedures designed to streamline the paternity establishment process. These include the use of default orders, a presumption of paternity based on genetic test results, conditions for admission of genetic test results as evidence, and expedited decision-making processes for paternity cases in which title IV-D services are being provided. In addition, this final regulation amends the Child Support Enforcement program regulations governing the audit of State Child Support Enforcement (IV-D) programs and the imposition of financial penalties for failure to substantially comply with the requirements of title IV-D of the Act. This regulation specifies how audits will evaluate State compliance with the requirements set forth in title IV-D of the Act and Federal regulations, including requirements resulting from the Family Support Act of 1988 and section 13721 of OBRA '93. This final regulation also redefines substantial compliance to place greater focus on performance and streamlines Part 305 by removing unnecessary sections.

Child Welfare↗
PubMed1982

Refugee resettlement program and Cuban/Haitian entrant program: cash and medical assistance policies. Social Security Administration. Interim final rule.

This interim final regulation amends the refugee resettlement program regulations (45 CFR Part 400) and establishes new policies on cash and medical assistance available to refugees and Cuban and Haitian entrants who are ineligible for Aid to Families with Dependent Children (AFDC), Supplemental Security Income (SSI), adult assistance (OAA, AB, APTD, and AABD) in the Territories and medicaid. The Refugee Resettlement Program (RRP) provides Federal reimbursement to States for 100 percent of the costs of cash and medical assistance provided, during the first 36 months after entry into the United States, to such refugees in accordance with applicable program rules and requirements and the administrative costs of providing such assistance. Cash assistance provided to such refugees under the RRP is termed "refugee cash assistance" (RCA); and medical assistance provided to such refugees under the RRP is termed "refugee medical assistance" (RMA). This regulation permits 100 percent Federal reimbursement for RCA and RMA for an eligible refugee for the first 18 months that a refugee is in the United States. For a refugee who has been in the U.S. more than 18 months but less than 36 months, the regulation permits a State, at its option, to seek RRP reimbursement for the cost of General Assistance (GA) provided to such a refugee.

Cuba↗
PubMed1998

Medicare program; recognition of the American Association for Accreditation of Ambulatory Surgery Facilities, Inc. for ambulatory surgical centers program-HCFA. Final notice.

This notice announces the approval of the American Association for the Accreditation of Ambulatory Surgery Facilities, Inc. (AAAASF) as an accreditation organization acknowledged by the Medicare program. We have found that AAAASF's standards for ambulatory surgical centers (ASCs) meet or exceed those established by the Medicare program. ASCs accredited by AAAASF will receive deemed status under the Medicare program.

Accreditation↗