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Program Evaluation Projects
Assessments of Various Strategies and Activities in Title X Family Planning Clinics
In a study conducted for the Department of Health and Human Services Office of Population Affairs, HSR evaluated HIV prevention activities in Title X family planning clinics in order to determine which activities were most effective, identify available resources, and disseminate information about successful approaches. HSR also examined the couples-based strategies used in Title X clinics that are intended to include men in contraceptive decision-making, STD prevention, and overall health improvement for families. In conducting these evaluations, HSR used a literature review, key-informant interviews, site visits, and focus groups with clients to determine challenges, promising practices, and recommendations.
Evaluation of the Impact of the Ryan White Comprehensive AIDS Resources Emergency (CARE) Act Minority AIDS Initiative on Recruiting and Retaining HIV-infected Persons of Color into Care
In a study conducted for Health Resources and Services Administration's HIV/AIDS Bureau, HSR will evaluate the efforts and successes of the CARE Act grantees as they modify services to recruit and retain HIV-infected people of color. HSR will design a sample methodology to include diverse grantees and gather comparison data on the racial and ethnic makeup of HIV/AIDS in service areas, in part through interviews with 250 grantees. HSR will compile their findings in a final report, identifying effective models and promising practices for the treatment of this underserved population.
Evaluation of the BodyWorks Toolkit
HSR is undertaking an evaluation of the BodyWorks Toolkit for the Department of Health and Human Services Office on Women's Health. BodyWorks is an obesity prevention program developed to help parents and caregivers of adolescent girls improve family eating and exercise habits. HSR will assess both the program impacts and its train-the-trainer implementation method.
Pennsylvania Maternal and Child Health (MCH) Needs and Capacity Assessment
HSR conducted a needs and capacity assessment for the Commonwealth of Pennsylvania, focusing on the MCH service system and the needs of MCH populations, which include children with special health care needs. HSR used a multifaceted approach to gather, analyze, and report data, and the evaluation included both qualitative and quantitative research from primary and secondary sources. HSR also conducted stakeholder meetings across the State and produced findings and recommendations for the State Title V staff and its partners.
New York Attention Deficit Hyperactivity Disorder (ADHD) Study
HSR is studying the quality of care for Medicaid recipients ages 6-12 with ADHD. Conducted for the New York State Department of Health and the State external quality review organization, the study consists of parent focus groups in English and Spanish and interviews with Medicaid managed care organizations and health providers, including pediatricians, family practitioners, and mental health specialists. The final report will include recommendations to the State for developing quality improvement initiatives to improve services to children with ADHD.
Determining the Feasibility of Evaluating the Vaccine Injury Compensation Program (VICP)
HSR is conducting an evaluability assessment for the Health Resources and Services Administration's Division of Vaccine Injury Compensation to determine the feasibility of conducting a comprehensive evaluation of the VICP. The VICP aims both to compensate individuals who are injured by federally mandated vaccines and to provide vaccine companies and health care providers who administer vaccines with protection from vaccine related lawsuits. If a full evaluation is feasible, HSR will conduct the evaluation to determine whether the VICP is meeting its goals. If a comprehensive evaluation is not feasible, HSR will undertake a tailored evaluation that will make the best use of available resources to examine the most pressing issues facing the VICP.
Evaluation of the Bright Futures Women's Health and Wellness (BFWHW)
In collaboration with the BFWHW staff, Steering Committee, and Executive Management Committee, HSR planned and conducted an evaluation for the Human Resources and Services Administration's Office of Women's Health. The evaluation assessed the initiative's pilot tools for physical activity and healthy eating. In support of the evaluation, HSR successfully provided data collection training, support, and monitoring to selected evaluation sites, and our findings shaped revisions to the pilot materials and identified options for outcome evaluation efforts. Subsequently, HSR received the contract to conduct the intermediate outcome evaluation of the BFWHW physical activity and healthy eating initiative in several diverse clinical and community settings across the country. Results will be presented in a manuscript for publication in a peer-reviewed journal.
Evaluation of States' Title V Needs Assessment Activities
In a 2006 evaluation for the Maternal and Child Health Bureau (MCHB), HSR analyzed the impact of State infrastructure-building activities aimed to address the MCHB needs identified in the 2000 needs assessment. In an evaluation that included both qualitative and quantitative analyses, HSR examined trends, promising practices, State implementation and planning, and correlations between infrastructure-building and MCHB outcomes. HSR then translated these research findings to produce a valuable guide, which provides Title V agencies and MCHB programs practical recommendations for conducting MCHB needs assessments.
Evaluation of the National Women's Health Week (NWHW)
NWHW is a national effort that aims to channel simple, practical health messages to a broad audience of women through a range of local media, public events, and creative networks during the course of 1 week each year in May. In an evaluation conducted for the Department of Health and Human Service's Office on Women's Health (OWH), HSR will assess the 2006 NWHW using a combination of informant interviews, participant surveys, and focus groups. The goal of the evaluation is to establish baseline data for future evaluations and to assess implementation strategies, organizational and group participation motives, and event impacts, which will help OWH to assess the implementation and outcomes of this initiative.
Evaluation of Participant-centered Nutrition Education in the Washington, DC, Women, Infants, and Children (WIC) Program
HSR is evaluating the training and implementation of Participant-centered Nutrition Education in the Washington, DC, WIC program. Four sites (two that are primarily African-American and two that are primarily Hispanic) will serve as intervention sites, while two sites will function as controls. Staff assessments will be made using surveys and interviews. Self-report surveys administered three times to the caregivers over a 4-month period will be used to measure client outcomes and satisfaction.
Arizona and Virginia Women, Infants, and Children (WIC) Funding Formula Development
HSR is conducting an assessment of the current WIC funding formulas used by Virginia and Arizona to provide funds to local WIC agencies. The HSR Team is assessing the strengths and weaknesses of each States funding formula, interviewing other States to assess potential features that should be included in a new funding formula, and developing a set of alternatives for consideration. Once a new formula is selected, HSR will train local WIC agencies on how the formula works and how to best take advantage of features and incentives.
Women, Infants, and Children (WIC) Program for Participant-Centered Nutrition Education
HSR recently has begun a project to assist 11 States in the U.S. Department of Agriculture's Food and Nutrition Service's Western Region with developing and implementing participant-centered nutrition education programs. HSR will develop and implement statewide assessments of program readiness to conduct participant-centered nutrition education, provide technical assistance in the implementation of pilot programs, and assist with the development of an evaluation tool to assess program acceptance and satisfaction, as well as outcomes.
Evaluation to Determine the Effectiveness of the Public Assistance Reporting Information System (PARIS)
In a study conducted for the Agency for Children and Families, HSR is analyzing the effectiveness of the PARIS project, a program designed to match Medicaid, Temporary Assistance for Needy Families, and Food Stamp participation data across participating States to identify and reduce duplicate participation. Program participation data are matched with Federal employment records and records from the Department of Veterans Affairs in order to reduce duplicate improper payments made to ineligible participants. In addition, HSR will provide technical assistance to new States joining the PARIS project in Fiscal Year 2007.
National Evaluation of the Bright Futures for Infants, Children and Adolescents Initiative
The Bright Futures Initiative, launched in 1990, aims to improve the quality of health services for children through health promotion and disease prevention. HSR conducted the first national evaluation of the Bright Futures for the Health Resources and Services Administration (HRSA) Maternal and Child Health Bureau. HSR examined the nature and extent of Bright Futures-related activities through a process evaluation and developed an outcome evaluation plan in collaboration with the Bright Futures Evaluation Workgroup. HSR also conducted a series of case studies exploring how Bright Futures has been used in public child health promotion efforts in seven States. HSR developed a resource guide for States and communities on how to use Bright Futures in their own efforts to improve the health of children and the quality of care they receive. The products of this evaluation are available at:
Evaluation of the Maternal and Child Health Bureau's State Oral Health Collaborative Systems Grant Program (SOHCS)
SOHCS was designed to support State oral health programs and improve the integration of oral health into other systems of care for women and children. HSR's evaluation will assess the progress of 47 grantees who have engaged in continuous activities since the inception of the SOHCS program. Additionally, HSR will study the degree to which the grantees, both individually and collectively, have integrated oral health successfully into existing systems of care. The evaluation will include site visits, phone interviews, literature reviews, the collection of quantitative data, and the development of a database for the Health Resources and Services Administration (HRSA) Maternal and Child Health Bureau.
Community Mental Health Services Block Grant Evaluation
HSR is conducting the national, independent evaluation of the Community Mental Health Services (CMHS) Block Grant of the Substance Abuse and Mental Health Services Administration's Center for Mental Health Services. This block grant is the only program that provides funds to every State and Territory for the development of a comprehensive, community-based system of care for individuals with serious mental illness (SMI) and severe emotional disturbance (SED) who have no mental health coverage.
The evaluation includes a comprehensive examination of Federal and State resources, processes, and outputs related to the Block Grant. Every State and Territory that receives block grant funds will be included in this evaluation, and many mental health stakeholders will be asked to participate in surveys and interviews conducted by HSR. The evaluation is designed to assess whether the block grant program is efficient, effective, and achieving positive results for the populations it serves.
Evaluation of the St. Louis Healthy Start Project
The goal of the Healthy Start project in St. Louis is to promote positive pregnancy outcomes in selected high-risk communities. Project staff members are skilled in the delivery of community services but generally are less familiar with conducting program evaluations and using their results. HSR's strategy has been not only to conduct the evaluation but also to strengthen the evaluation skills of project staff. HSR has drafted a results-focused monitoring and evaluation framework; conducted training/feedback sessions with program staff members to help them become more comfortable with evaluation and to recognize its usefulness; worked with staff to support the development of a database; and provided evaluation results to the project. In the end, this project will be successful when program staff takes ownership of the evaluation process.
Evaluation of Food Stamp Nutrition Education Program
HSR is conducting, for the second time, a national evaluation of Food Stamp Nutrition Education programs. The goals of the evaluation include assessing how State-level program organization affects program development, nutrition message development, coordination, and delivery on a local level, as well as evaluating the use of matching funds and inkind matching contributions. The evaluation will be conducted by collecting survey data from a census sample of State offices and organizations overseeing and implementing this education as well as through onsite interviews in a sample of States. From evaluation results, we will refine and validate a checklist of program characteristics that the evaluation has shown to be associated with quality programs. HSR developed the checklist at the beginning of this work with the assistance of an expert panel.
Dissemination and Evaluation Planning for Surgeon General Reports
HSR developed tools to assist the Office of the Surgeon General (OSG) in developing dissemination plans and strategies to evaluate the impact of future Surgeon General reports. The tools were developed after HSR conducted document analyses, key-informant interviews, and an extensive literature review and held an expert panel meeting with former Surgeon General's Report managers and experts in the fields of health literacy, health promotion, social marketing, health communication, and evaluation.
WIC and Primary Care Coordination: Best Practices and Lessons Learned
For the U.S. Department of Agriculture, HSR developed a best-practices handbook to promote and facilitate the coordination and integration of the Women, Infants, and Children (WIC) program with health care and socialsupport services provided through Community/Migrant Health Centers (C/MHC) and Indian Health Services (IHS) clinics. The handbook was designed to motivate WIC, C/MHC, and IHS providers to develop and implement concrete action plans to strengthen coordination. To conduct this work, HSR convened an expert panel; developed interview protocols and conducted interviews to assess 135 potential best-practice sites; and designed, wrote, and pretested the handbook in collaboration with a cultural competency expert and a communications/marketing agency in order to increase the relevance and utility of the product.
Bright Futures for Women's Health and Wellness: A Formative Evaluation
The Health Resources and Services Administration's Office of Women's Health launched the Bright Futures for Women's Health and Wellness Initiative to support preventive health care for women by developing tools they can use with their providers. HSR designed and conducted an evaluation in three large health clinics to determine how a nutrition and physical activity tool was used and what its immediate impacts were. Findings were used to revise the tool and materials developed to help clinical sites incorporate the tool into their practice. The evaluation used surveys and semistructured interviews cleared by the Office of Management and Budget. We developed a logic model as well as an evaluation plan to assess short- and long-term results of the initiative.
Bright Futures for Infants, Children, and Adolescents Initiative
This effort, launched in 1990 with funding from the MCHB, fosters a developmentally based approach to childhood health promotion and disease prevention in the context of families and communities. In 2002, HSR was awarded a contract to conduct the first national evaluation of Bright Futures. Under this contract, HSR has conducted a large process evaluation to assess Bright Futures-related dissemination, adoption, and practice activities at the national, State, and community levels. HSR also developed an annotated bibliography of Bright Futures materials and collaborated with a group of Bright Futures stakeholders to develop an outcome evaluation plan for this initiative. HSR currently is conducting case studies in six States that are actively using Bright Futures in their child health promotion efforts.
Copies of the process evaluation report and other resources are available at:
Evaluation of the St. Louis Healthy Start Project
Building on HSR's role in the national evaluation of the original Healthy Start sites, HSR is working with the St. Louis Healthy Start project focused on promoting positive pregnancy outcomes in select high-risk communities of St. Louis. HSR's strategy was not only to conduct an evaluation, but also to strengthen the evaluation skills of grantee staff. HSR drafted a results-focused monitoring and evaluation framework consistent with the goals of the project, and has provided training with project staff and community stakeholders on the evaluation framework and its usefulness in conducting successful programs.
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