The subpoena and a day in court: guidelines for nurses

Psychiatric nurses or therapists may be subpoenaed to appear as direct or expert witnesses. The response must be carefully prepared, and nurses must be aware that testifying in court can be an anxiety-provoking experience. Testifying often involves being an advocate for a client. Clients who have a mental illness, are developmentally disabled, or have a history of abuse or recent violence deserve a conscientious response. The legal process is the avenue for providing safety or empowerment, for assuring that needs are met, and rights are obtained, and being part of that process is an important role. Being prepared for the role is essential.     

Examination of variable errors of measurement in a survey-based social indicator

The sample survey, involving the use of specially developed questionnaires and instruments, is an important source of data regarding individual experiences and social-psychological characteristics for use in social indicator research. Variable errors of measurement are often given only cursory attention in presentations of survey sampling and social indicator theory and in the analysis of such data. These errors may, however, result in reduced precision of estimates and may affect statistical inferences drawn from the data. Some procedures for assessing the extent of variable measurement error are described and examples of their use in evaluating a survey instrument and data collected are discussed.     

Examining the link between program implementation and behavior outcomes in the lifestyle education for activity program (LEAP)

Lifestyle Education for Activity Program (LEAP) was a comprehensive, school-based intervention designed to promote physical activity in high school girls. The intervention focused on changes in instructional practices and the school environment to affect personal, social, and environmental factors related to physical activity. Multiple process evaluation tools and an organizational assessment tool were developed to monitor program implementation from a framework called the LEAP essential elements, which characterized complete and acceptable intervention delivery; secular trends were also monitored. Using process data, LEAP intervention schools were categorized into low- and high-implementing groups and compared with control schools on nine essential elements assessed at the organizational level. The Wilcoxon scores test revealed that low- and high-implementing intervention, and control schools differed significantly on two of nine administrator-reported organizational-level components: having a physical activity team and having a faculty-staff health promotion program. A mixed-model analysis of covariance indicated that, compared to control schools, a greater percentage of girls in high-implementing schools reported engaging in vigorous physical activity. Process evaluation can be used to understand the relationship between level of implementation and successful program outcome.     

Assessing Performance Budgeting at OMB: The Influence of Politics, Performance, and Program Size

This article investigates the impact of performance, as measuredby the OMB performance budgeting initiative called PerformanceAssessment Rating Tool (PART), on recommendations in the President'sbudget. In a multivariate analysis using data from the FY 2005budget, with appropriate controls for the political contentof programs, we find that the PART scores have a statisticallysignificant impact on budget decisions within OMB. We find thatPART scores have a larger impact on small and medium sized programsthan on large programs. We also find that the "results" componentof PART scores has a smaller impact on budget decisions thanthe "program purpose" component, a finding which tends to contradictthe goal of performance budgeting to redirect resources to programsthat produce results. The relative unimportance of the "results"component may be due to the lack of good outcome measures formost programs in PART.     

The Social Work Assessment Tool (SWAT)

This paper reports on the last of three National Hospice and Palliative Care Organization initiatives to move hospice and palliative care social workers into the patient/family outcomes arena: the development of the Social Work Assessment Tool. The experience of a team of practitioners and researchers is described, including results of two pilot studies and subsequent SWAT revisions. The major focus is on the current model performance improvement project, in which 19 social workers from 14 hospice and palliative care programs used the SWAT with 101 patients and 81 primary caregivers for a median of 44 days. Quantitative analysis indicated significant improvement in SWAT scores for patients from the first to the second social work visit (t = -2.60, df = 47, p .01). Qualitative interviewing of the social workers indicated some lack of readiness in the field to conduct quantitative outcomes measurement. Additional measures are needed in addition to the SWAT, including qualitative measures, and measures of mezzo and macro practice. Participants indicated that the SWAT was appropriate for use with economically and culturally diverse clients.