Quality of life in the evaluation of community support systems

As a result of the authors' experience in conducting an evaluation of the community support system (CSS) program in New York State, they have identified five reasons for focusing on quality of life (QOL) as a desired outcome for programs for the chronically ill. These reasons are presented and problems in QOL evaluative research are discussed. Psychological indicators are distinguished from social indicators of QOL, and two methods of operationalizing perceived QOL, the psychological well-being and life domains methods, are examined. A conceptual model is presented and the results of an exploratory study of the QOL of 118 chronic psychiatric patients receiving CSS services are presented.     

Risk assessment of sex offenders: the current position in the UK

This paper examines the various risk factors that are considered in the current risk assessments used with sex offenders, and the strengths and weaknesses of each. In addition, particular attention is given to the assessments that are currently employed within the prison and probation services. Static instruments, dynamic instruments and combined approaches are evaluated, as are clinical assessments of risk. In particular, the now commonly used joint Prison‐Probation Offender Assessment System risk prediction instrument (OASys) is considered, with an evaluation of the relevance of the factors included in making an assessment of risk and whether this is supported by research into recidivism amongst sex offenders. Copyright © 2006 John Wiley & Sons, Ltd.     

Perception of Substance Use Problems in Asian American Communities by Chinese,Indian, and Vietnamese American Youth

SUMMARY

The study was a cross-sectional survey using a convenience sample of 87 Asian American youth respondents to examine their perceptions of substance use problems in the Asian American community. The authors examined respondents' perceptions of the severity of substance use problems in the Asian American community, perceived characteristics of persons with problems of substance use, perceived etiology of substance use problems, beliefs about treatment, perceived help-seeking preferences and helpful services. The youth demonstrated an increased awareness of the severity of substance use problems in the community, although such awareness was more prominent for drinking problems than drug use problems. Respondents showed a positive attitude toward treatment, although such an attitudinal change was not yet accompanied by a change in their behavioral preferences. Findings suggested a tendency for Asian American youth respondents to utilize personal resources rather than professional help or formal treatment programs in response to substance use problems. In addition, respondents shared similar “myths” of Asian problem drinkers and drug users. Implications for developing culturally relevant interventions for prevention and treatment as well as future research are discussed.     

Program analysis using the client oriented cost outcome system.

The client oriented cost outcome system has been under development in Pennsylvania community and hospital programs since 1972. The system builds upon the behavioral and decision data generated with or on behalf of consumers. Flexibility for local program system design is permitted if the procedures of consumer intake, review, and termination document each consumer's (a) problems, resources, and goals, (b) overall functioning level in their ordinary community, and (c) services intended and rendered as related to (a), above. While the system's primary application is in providing feedback for local program quality assurance and evaluation procedures, aggregation of data permits program planning and evaluation at county, state, and federal levels in terms of (a) client demographic or diagnostic characteristics, and (b) program service characteristics and objectives.     

Juvenile Offender Recidivism: An Examination of Risk Factors

One hundred and seventy three male juvenile offenders were followed two years postrelease from a residential treatment facility to assess recidivism and factors related to recidivism. The overall recidivism rate was 23.9%. Logistic regression with stepwise and backward variable selection methods was used to examine the relationship between recidivism and nine specific variables: offense type, age at initial involvement in juvenile justice, child welfare system involvement, termination of parental rights, parental criminal history, family support, program completion status, length of treatment stay, and discharge placement. Offender type was the only factor found to have a significant impact on recidivism with general and substance-involved offenders more likely to recidivate than sex offenders. Implications for future research are discussed.     

Juvenile offender recidivism: an examination of risk factors

One hundred and seventy three male juvenile offenders were followed two years postrelease from a residential treatment facility to assess recidivism and factors related to recidivism. The overall recidivism rate was 23.9%. Logistic regression with stepwise and backward variable selection methods was used to examine the relationship between recidivism and nine specific variables: offense type, age at initial involvement in juvenile justice, child welfare system involvement, termination of parental rights, parental criminal history, family support, program completion status, length of treatment stay, and discharge placement. Offender type was the only factor found to have a significant impact on recidivism with general and substance-involved offenders more likely to recidivate than sex offenders. Implications for future research are discussed.     

Treatment Strategies for Juvenile Delinquency: Alternative Solutions

Social workers involved in the treatment of adjudicated youth commonly encounter youth sentenced to traditional incarceration or parole as a path to rehabilitation. This article examines alternative treatment strategies for adjudicated youth, namely Victim Offender Reconciliation Programs (often called mediation), Boot Camps, and Wrap-Around Community-Based Care, to help these youth avoid reoffending. While popular with the media, policymakers, or the general public, an evaluation of the literature makes it clear that these programs do not necessarily guarantee lower recidivism rates for program participants. It is evident that further research and evaluation must be done in order to more fully understand the drawbacks and benefits of alternative strategies, and to more appropriately help adjudicated youth and their communities.     

Impacts of agency coordination on nonprofit domestic violence and sexual assault programs in communities with STOP formula grant funding

The goals of the current study are (a) to understand the community and state context in which STOP(Services* Training* Officers* Prosecutors)-funded victim service (VS) programs operate, (b) to assess the degree to which receipt of STOP funding for VS programs and the degree of state-level STOP agency support for collaboration among community agencies have led to improved program services and community interaction, and (c) to assess the degree to which improved interaction between community agencies leads to improvements for VS programs. The results show that community interaction between VS programs and other community agencies can improve VS program services as reported by service providers. In addition, the higher the pre-STOP levels of activity around violence against women issues in communities, the more agencies can enhance their service system with STOP funding. Also, STOP funding has facilitated greater levels of change for communities whose pre-STOP attention to violence against women was lower.     

SenseMaker® as a monitoring and evaluation tool to provide new insights on gender-based violence programs and services in Lebanon

Monitoring and evaluation (M&E) of gender-based violence (GBV) programs is challenging in humanitarian settings. To address these challenges, we used SenseMaker® as a mixed methods M&E tool for GBV services and programs in Lebanon. Over a three-month period in 2018, a total of 198 self-interpreted stories were collected from women and girls accessing GBV programs from six service providers across five locations. The resultant mixed-methods analysis provided holistic and nuanced insights on how perceived benefits differed by type of GBV program, how motivations for accessing programs differed by location, and how feelings while accessing programs differed by participant nationality. SenseMaker reinforced the intersectionality between events leading up to the accessed services, the experiences of accessing the services, and subsequent outcomes as a result of having accessed the services, helping to contextualize the findings within the broader experiences of participating women and girls. Limited literacy and technology skills among participants proved to be a challenge and future work should investigate how technology might facilitate use of the tool among participants with lower literacy and technology skills in addition to exploring the feasibility and added value of SenseMaker as an M&E tool in acute humanitarian settings.     

Faith-Based Programs and the Role of Empirical Research

Abstract

After some decades of being subject to neglect or contempt, faith-based social care programs are receiving increased attention and resources enabling them to undertake a greater role in the national network of human services. Faith-based programs receiving public support can expect to be rightly scrutinized by the public, in terms of their ability to attain professed program goals. The tools of conventional empirically-oriented program evaluation research have tremendous potential to help demonstrate the effectiveness of faith-based programs, which will justify their receipt of ongoing support from public funds. Negative research findings can be properly scrutinized by the faith-based community of service providers to help make tough, data-based, decisions on funding priorities. Several examples are described, illustrating how various types of faith-based programs have profitably participated in program evaluation studies.     

Where Do We Stand? Testing the Foundation of a Shared Site Intergenerational Program

Abstract

Shared site intergenerational care programs provide ongoing services simultaneously to old and young community members at a single facility, thereby, meeting the care needs of multiple generations. However, they face the challenge of sustainability common to all community-based programs. We employed the results management model to identify program elements that may enhance or inhibit sustainability of intergenerational programming at a shared site facility involving a child development lab school and adult day services program. The 4-step results management approach is a strengths-based model that supports community capacity and achievement of community and program goals. The current paper describes the first step in the results management approach, mapping the terrain, which involves gathering evidence of community needs and strengths. Focus groups were conducted with eleven staff members from both programs after a 4-month intergenerational program. The focus groups targeted the needs and strengths related to intergenerational programming. Respondents identified strengths that enhanced staff members' and clients' capacity for collaboration. These included affective and developmental benefits for both generations and strong partnerships between staff members. Respondents also identified factors that limited collaboration, such as the need for greater authority support and cross-training opportunities. Findings from our study have been used by program administrators to continue using the results management approach to further build intergenerational community and expand the scope of evaluating intergenerational shared site programs. Other intergenerational programs may utilize the results management model to enhance intergenerational programming and increase program sustainability.     

The evaluation and monitoring of a Medicaid second surgical opinion program.

The evaluation of newly implemented and controversial programs often present real problems for the evaluator. When a program is accompanied by a legislatively mandated evaluation, the issues become even more acute. The evaluator, wanting to impact on policy, must strike a balance between the adherence to principles of scientific inquiry, yet be responsive to the needs of policymakers. This paper describes the evaluation and follow-up monitoring of a recently established second opinion program for Medicaid recipients. The program was to terminate in 17 months unless extended by the Wisconsin Legislature. The evaluation found, among other things, marked reductions in the use of surgical services after implementation of the second opinion program. Based in large part on the evaluation, the program was extended with a provision for continued monitoring. The paper discusses the factors that contributed to the evaluation having a major impact on the decision to extend the program.     

Evaluation of the Integrated Services Pilot Program from Western Australia

Independent evaluation of refugee-focused programs in developed nations is increasingly a mandatory requirement of funding bodies and government agencies. This paper presents an evaluation of the Integrated Services Centre (ISC) Pilot Project that was conducted in Australia in 2007 and early 2008. The purpose of the ISC program was to provide integrated support to humanitarian refugees in settlement, physical health, mental health and employment. The Pilot Project was based in two primary schools in Perth, Western Australia. The evaluation utilized a flexible qualitative ‘engaged’ methodology and included interviews, focus groups and telephone interviews with the key stakeholders, project staff and a small number of refugee families. The strength of the qualitative methodology (including data that is narrative rich) is that it highlights issues as perceived by each stakeholder and provides insights into the daily work by ISC staff that helped to uncover unintended outcomes. Despite the fact that the ISC evaluation was supposed to be a ‘before and after’ design, the researchers acknowledge a common weakness in many evaluations (including the ISC) that when baseline data is required, evaluators are recruited after the project has begun. This issue is discussed in the paper. It is critical that independent evaluators are able to begin collecting baseline data as soon as programs are launched, if not before.     

A model for a comparative cost-effectiveness evaluation of two mental health partial care programs.

This study provides a model for comparing the cost-effectiveness of two mental health programs. The example cited examines the cost-effectiveness of a hospital-based and a community-based partial care program. Using each group as its own control, the authors compare patients' use of inpatient hospitalisation and emergency room services during one year prior to and one year subsequent to first admission in day care. In both day care programs, patients substantially reduced their number of inpatient admissions and days. Neither program, however, showed a significant decrease in patients' use of the emergency room. Reflecting the substantially lower costs of the community-based program, the benefit-cost and cost-effectiveness ratios were significantly better in the community-based program than in the hospital-based program. Based on this evidence the authors conclude that the lower-cost, equally effective community-based program should be carefully considered as an alternative for more partial care patients.     

Qualitative cost–benefit evaluation of complex,emergent programs

This paper discusses a methodology used for a qualitative cost–benefit evaluation of a complex, emergent program. Complex, emergent programs, where implementation varies considerably over time and across sites to respond to local needs and opportunities, present challenges to conventional methods for cost–benefit evaluation. Such programs are characterized by: ill-defined boundaries of what constitutes the intervention, and hence the resources used; non-standardized procedures; differing short-term outcomes across projects, even within the same long-term goals; and outcomes that are the result of multiple factors and co-production, making counter-factual approaches to attribution inadequate and the use of standardized outcome measures problematic. The paper discusses the advantages and limitations of this method and its implications for cost–benefit evaluation of complex programs.     

Malawi goes to scale with anti-AIDS clubs and popular media

This paper evaluates a project in Malawi that aimed to provide in-school and out-of-school youth with the necessary tools and skills to avoid high-risk sexual behavior, in order to reduce HIV transmission. Project components were school curriculum; extra-curricular activities; out-of-school youth clubs; enabling environmental support; youth reproductive health services; and research, monitoring and evaluation. Non-governmental organizations (NGOs) and Youth Technical Committees established 3200 anti-AIDS Clubs throughout Malawi. These Clubs positively influenced members' behavior and helped to ‘break the silence’. An enabling environment was created through two popular radio programs, advertisements and provision of sports equipment. The out-of-school youth clubs needed clearer criteria and objectives. Many objectives were achieved, but the aim of establishing health services for youth was over-ambitious, and not achieved. This program is exemplary for the national scale that it achieved, and for its approach of using diverse partners to implement locally adapted components.