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Office of the Assistant Secretary for Planning and
Evaluation |
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Policy Information Center |
The abstracts below provide
brief descriptions of the 71 evaluation reports completed by Public Health
Service Agencies and the Office of the Assistant Secretary for Health (OASH)
during fiscal year 1994. The abstracts are listed by alphabetical order of the
Agencies, followed by OASH. The sponsoring Agency, report title, abstract, and
Federal contact person(s) are listed for each evaluation report. For more
information on any of the studies, please see the contact person(s) listed at
the end of the abstract. It may be possible to obtain copies of some
evaluations in two ways:
Policy Information Center Final
reports for most of the studies listed in this appendix have been submitted to
the Department of Health and Human Services (DHHS) Policy Information Center
(PIC), a centralized source of information on in-process, completed, and
ongoing health and human services evaluations; short-term evaluative research;
and policy-oriented projects. The PIC maintains a resource database containing
information on more than 6,000 completed and ongoing studies sponsored by DHHS,
other Federal Agencies, and private sector entities.
The PIC identification number appears after the Federal
contact person(s) information. The PIC provides executive summaries (where
available) at no cost. For more information about using PIC resources, please
contact--
Policy Information Center
Office of the Assistant
Secretary for Planning and Evaluation
Department of Health and Human
Services
Room 438F, Hubert H. Humphrey Building
200 Independence Avenue
SW
Washington, DC 20201
(202) 690-6445
National Technical Information Service
The National Technical Information Service (NTIS) is an
information clearinghouse run by the Department of Commerce. It provides
reports in both paper and microform formats for a fee. If a final report has
been registered with this service, the NTIS accession number follows the
Federal contact person(s) information. For more information about ordering
copies of Government reports from NTIS, please contact--
National Technical Information Service
Department of
Commerce
5285 Port Royal Road
Springfield, VA 22161
(703)
487-4650
Agency for Health Care Policy and Research
Listing of Abstract Titles
Analysis of Peer and Pilot Review Data Clinical Practice
Guidelines
Evaluation of Cost Analyses Conducted on Clinical Practice Guidelines:
Final Report
Identification of Data Sources Appropriate for Use in Conducting Cost
Analysis Required for the Development of Clinical Practice Guidelines: Final
Report
Overcoming Barriers to Integration and Implementation of Clinical
Information Management Systems
Report on Inappropriate Extension of Hospitalization
Research on the Cost Effectiveness of Managed Care Health Plans: A
Literature Review
TITLE: Analysis of Peer and Pilot Review Data
Clinical Practice Guidelines
ABSTRACT NUMBER: 001
ABSTRACT: The Agency for Health Care Policy and
Research (AHCPR), through its Office of the Forum for Quality and Effectiveness
in Health Care (Office of the Forum), is mandated by Congress to develop
clinical practice guidelines. This development process includes a review of
draft guidelines by independent health practitioners and other relevant
professionals to provide information about their quality and potential
usefulness (peer review). Additional information can be obtained about a
guideline's value if its recommendations are assessed in patient care
situations by practicing clinicians (pilot review). The purpose of this project
was to review and analyze the results of peer and pilot testing for six
AHCPR-sponsored guidelines and to develop recommendations for future peer
review and pilot testing methodologies. This contract culminated in a report
that offered several recommendations for improving peer and pilot review
procedures, including limiting the number of peer and pilot reviewers to 50;
increasing the number of primary care, consumer advocate, and nonphysician
reviewers; improving the yield of completed reviews by contacting potential
reviewers in person; providing improved instructions to reviewers; providing
longer timeframes for organizational reviews; and drafting a rationale for
changes recommended for a guideline when review comments are evaluated and
saving this draft as documentation of the panel's deliberations.
FEDERAL CONTACT OFFICE: Office of Program
Development
PERSON: Irma Arispe
PHONE NUMBER: 301/594-1455
PIC NUMBER: 5651
PERFORMER ORGANIZATION: Harvard University School
of Public Health, Boston, MA
P.I.: R. Heather Palmer, M.D.
TITLE: Evaluation of Cost
Analyses Conducted on Clinical Practice Guidelines: Final Report
ABSTRACT NUMBER: 002
ABSTRACT: This study examined the methodologies
and data sources used in cost studies for eight clinical practice guidelines
(urinary incontinence, pressure ulcers, cataract, depression, low back pain,
otitis media, benign prostatic hyperplasia, and sickle cell anemia). It was
found that the primary distinction among the studies was whether they estimated
treatment costs under the guidelines. Analysts in the studies that did not
estimate treatment costs felt it would require too many assumptions to do so.
They were concerned about the assumptions that must be made to estimate
treatment costs and made the following recommendations: reduce the number of
assumptions necessary to estimate treatment costs and restrict the empirical
analysis to the direct medical costs of treatment; compare treatment patterns
and costs before and after guideline implementation; use a variety of data
sources--such as administrative claims, clinical trials, and medical record
abstractions; use episodes of care as the unit of analysis, to provide a link
between the clinical and economic dimensions of the guidelines; use a
substantive expert as analyst, so that he or she is able to start on the
description of current practice immediately without waiting for guidance from
the panel; and emphasize the importance of the cost studies to the panels since
the panels are typically made up of medical professionals who may place greater
emphasis on clinical practice and outcomes and less emphasis on cost.
FEDERAL CONTACT OFFICE: Office of Program
Development
PERSON: Irma Arispe
PHONE NUMBER: 301/594-1455
PIC NUMBER: 5652
NTIS ACCESSION NUMBER: PB 95-193694
PERFORMER ORGANIZATION: SysteMetrics, Cambridge,
MA
P.I.: William Crown, Ph.D.
TITLE: Identification of
Data Sources Appropriate for Use in Conducting Cost Analysis Required for the
Development of Clinical Practice Guidelines: Final Report
ABSTRACT NUMBER: 003
ABSTRACT: Databases that provide cost information
relating to clinical guidelines have not been established. However, several
databases have been identified as worthy of investigation because of their
potential utility in estimating costs of guideline components. The purpose of
this study was to investigate the content of these databases, evaluate their
usefulness, develop a cost-measurement methodology using these existing
databases, and describe how the methodology could be used for selected
guidelines. It was determined that no one database can be used to estimate the
costs of clinical guidelines. Since often there are no data on certain services
in claims databases or there are significant questions about the accuracy of
available data, data must be assembled from several sources. Per-patient costs
for current and guideline patterns need to be multiplied by data on the
prevalence of the condition to arrive at aggregate cost for the United States.
In this calculation, differences in per-patient costs are projected to
understand overall impact.
FEDERAL CONTACT OFFICE: Office of Program
Development
PERSON: Irma Arispe
PHONE NUMBER: 301/594-1455
PIC NUMBER: 5653
NTIS ACCESSION NUMBER: PB 95-193652
PERFORMER ORGANIZATION: Center for Health Policy
Studies, Columbia, MD
P.I.: Benjamin Dugger, Sc.D.
TITLE: Overcoming
Barriers to Integration and Implementation of Clinical Information Management
Systems
ABSTRACT NUMBER: 004
ABSTRACT: The purpose of the feasibility study
was twofold: (1) to determine the practicality of studying the barriers to
implementation and integration of advanced clinical information systems and (2)
to specify the type of research design for an implementation study to
investigate these issues. Despite the promise of clinical information systems,
there have been few concerted research efforts to understand the barriers that
impede dissemination or the benefits that accrue from implementation. The
report presents the design for a major, and feasible, research study of
integrated health care information systems. With written letters of cooperation
from 24 institutions, the project would study 8 to 16 sites (depending on
funding level) representing 4 to 8 major vendor products and would focus on
both outcomes of implementation and barriers to adoption of system features.
The report provides details on study feasibility, site selection, research
design, and a data collection plan.
FEDERAL CONTACT OFFICE: Office of Program
Development
PERSON: Irma Arispe
PHONE NUMBER: 301/594-1455
PIC NUMBER: 5039
NTIS ACCESSION NUMBER: PB 95-193371
PERFORMER ORGANIZATION: ABT Associates,
Cambridge, MA
P.I.: Catherine Joseph
TITLE: Report on Inappropriate Extension of
Hospitalization
ABSTRACT NUMBER: 005
ABSTRACT: The purpose of this contract was to
perform a literature review and interview experts about inappropriate
hospital-stay extension and the role of discharge planning, and to produce a
summary document identifying research needs and potential existing data
sources. The project was undertaken to address a Senate Appropriations
Committee request for information on the extent to which inappropriate hospital
duration occurs, the reasons for such inappropriate extension of
hospitalization, and the extent to which hospital discharge planning can reduce
inappropriate continuation of hospital stays. The project also describes best
practices in hospital discharge planning. Key findings of the project are
these: 5 percent or more of total hospital days are likely to be accounted for
by extended stays that are not medically necessary, the cost of which is
conservatively estimated at $420 million in 1987 dollars; the reasons for
extended hospital stays include lack of sufficient nursing home beds and other
alternative placement settings, paperwork delays in qualifying patients for
posthospital benefits, and delays in appointing conservators for incompetent
patients. Discharge planning appears to have only a small impact on extended
hospital stays, but it may be having greater impact on appropriateness of
placement and the likelihood of readmission. The problem is pervasive, despite
incentives for early discharge. A solution is more likely to be a systemic
change coming from outside the hospital; or there may be some level beyond
which reduction of such stays is infeasible.
FEDERAL CONTACT OFFICE: Office of Program
Development
PERSON: Irma Arispe
PHONE NUMBER: 301/594-1455
PIC NUMBER: 5655
NTIS ACCESSION NUMBER: PB 95-193710
PERFORMER ORGANIZATION: Research Triangle
Institute, Washington, DC
P.I.: James S. Lubalin, Ph.D.
TITLE: Research on the
Cost Effectiveness of Managed Care Health Plans: A Literature
Review
ABSTRACT NUMBER: 006
ABSTRACT: The purpose of this project was to
identify, compile, categorize, and critically analyze published and unpublished
literature on the cost-effectiveness of managed health care plans, to draw
conclusions about the cost-effectiveness of various approaches to these plans
and indicate important remaining policy-relevant gaps in knowledge. Managed
care plans were compared with indemnity (fee-for-service) plans with regard to
utilization and cost performance. It was found that managed care plans had
lower hospital utilization, greater use of less costly alternatives to
expensive procedures and tests, greater use of preventive measures, comparable
quality of care, and somewhat lower enrollee satisfaction generally but much
greater satisfaction with cost. The study also concluded that policymakers need
much more evidence on managed care plan performance. It recommends funding
larger, more comprehensive research projects to determine what works in managed
care, rather than just whether managed care works.
FEDERAL CONTACT OFFICE: Office of Program
Development
PERSON: Irma Arispe
PHONE NUMBER: 301/594-1455
PIC NUMBER: 5654
PERFORMER ORGANIZATION: Center for Health Policy
Research, George Washington University, Washington, DC
P.I.: Michele Solloway, Ph.D.
Centers for Disease Control and Prevention
Agency for Toxic Substances and Disease Registry
Listing of Abstract Titles
Assessing Prevention Effectiveness: A Collaborative Effort With
Selected Health Maintenance Organizations (Phase I)
Assessment of Information Dissemination Activities--Office on Smoking
and Health
Congenital Syphilis: Estimated Direct Medical Care Cost for the United
States--1990
Development of an Evaluation Plan for DCPC's State-Based Comprehensive
Breast and Cervical Cancer Early Detection and Control Program
Estimating Expenditures for Chronic Hepatitis B
Evaluation of CDC and ATSDR Training Activities
Evaluation of National Health Interview Survey Diagnostic Reporting
Evaluation of Sexually Transmitted Disease Clinic Flow and
Utilization
Evaluation of the Morbidity and Mortality Weekly Report
Series
Lessons From Implementing State-Based Diabetes Control Programs: An
Evaluation
Report of the Working Group To Revise the Model State Vital Statistics
Act and Regulations
Vital Records Evaluation Using 1988 National Maternal and Infant Health
Survey Data
TITLE: Assessing Prevention Effectiveness: A
Collaborative Effort With Selected Health Maintenance Organizations (Phase
I)
ABSTRACT NUMBER: 007
ABSTRACT: This project, the first of a two-phase
study, reviewed existing health maintenance organizations (HMOs) to develop a
framework and the process to assess prevention effectiveness; the
characteristics, organization, and types of preventive services offered; and
the potential for working in collaboration with CDC. Based on essential
criteria developed to guide the process of site selection, a series of site
visits was conducted. A data collection instrument and semistructured interview
was conducted during each of the site visits. Strengths and weaknesses of HMO
data collection systems were identified and recommendations were provided to
CDC on which five HMOs would most appropriately meet the needs of CDC for phase
two of the study.
FEDERAL CONTACT OFFICE: Office of Program
Planning and Evaluation
PERSONS: Wilma Johnson, Nancy Cheal
PHONE NUMBER: 404/639-3453
PIC NUMBER: 4111
PERFORMER ORGANIZATION: Battelle, Arlington,
VA
P.I.: Bryan R. Luce, Ph.D.
TITLE: Assessment of
Information Dissemination Activities--Office on Smoking and Health
ABSTRACT NUMBER: 008
ABSTRACT: The purpose of this study was to
develop recommendations for key management and operational aspects of the
information dissemination function in the Office of Smoking and Health (OSH),
with particular emphasis on the response system. Although the study focuses on
information dissemination, its broader context is OSH's evolving leadership
role within the tobacco control community. The project consisted of internal
and external interviews. The external interviews were conducted with
individuals representing Federal Agencies that might be using information
approaches relevant to OSH. In addition to information dissemination models,
reports of site visits, and telephone interviews, the final report contains
recommendations to OSH on organizational considerations and strategic
planning.
FEDERAL CONTACT OFFICE: Office of Program
Planning and Evaluation
PERSONS: Wilma Johnson, Nancy Cheal
PHONE NUMBER: 404/639-3453
PIC NUMBER: 4684
PERFORMER ORGANIZATION: Macro International,
Atlanta, GA
P.I.: Katie Baer, M.P.H.
TITLE: Congenital
Syphilis: Estimated Direct Medical Care Cost for the United
States--1990
ABSTRACT NUMBER: 009
ABSTRACT: The purpose of this study was to
estimate the 1990 direct medical costs of congenital syphilis in the United
States. Three types of costs were included in the study: medical care incurred
during the first year of life; special education for infants who experience
impairment due to congenital syphilis; and lifetime custodial care for infants
who experience profound effects of congenital syphilis. After classifying cases
by severity, researchers created a computer model that integrated incidence
data with varying assumptions (such as case severity distribution, price level,
etc.). Based on the analysis, it is estimated that the present value of costs
for medical care, special education, and lifetime custodial care for the 1990
incident congenital syphilis cohort was in the range of $100-$200
million.
FEDERAL CONTACT OFFICE: Office of Program
Planning and Evaluation
PERSONS: Wilma Johnson, Nancy Cheal
PHONE NUMBER: 404/639-3453
PIC NUMBER: 5301
PERFORMER ORGANIZATION: Battelle, Washington,
DC
P.I.: Bryan R. Luce, Ph.D.
TITLE: Development of an
Evaluation Plan for DCPC's State-Based Comprehensive Breast and Cervical Cancer
Early Detection and Control Program
ABSTRACT NUMBER: 010
ABSTRACT: The primary purpose of this evaluation
was to collect data pertinent to program-related decisions. The evaluation
focused on State health agency breast and cervical cancer program components
(public education, provider education, quality assurance, surveillance,
screening, and followup) as well as the combined effect of program components.
Short-term, intermediate, and long-term program and health outcomes were
assessed. Assessment of program development and implementation was considered
along with traditional evaluations of program efficiency and
effectiveness.
FEDERAL CONTACT OFFICE: Office of Program
Planning and Evaluation
PERSONS: Wilma Johnson, Nancy Cheal
PHONE NUMBER: 404/639-3453
PIC NUMBER: 4744
PERFORMER ORGANIZATION: Research Triangle
Institute, Research Triangle Park, NC
P.I.: Thomas J. Cook, Ph.D.
TITLE: Estimating
Expenditures for Chronic Hepatitis B
ABSTRACT NUMBER: 011
ABSTRACT: The purpose of this effort was to
provide CDC with estimates of the direct medical cost of hepatitis B,
particularly the acute care costs of services rendered to individuals
identified as having or having had an episode of hepatitis B. These estimates
were developed using recent paid claims histories from reimbursement files for
persons recorded as having been treated for one or more specific diagnoses
associated with hepatitis B. Data collection proceeded on a dual track: both a
private market source and Medicaid data were obtained. The Medicaid data were
procured from the repository from the Tape-to-Tape data development effort
conducted for Health Care Financing Administration (HCFA). States that
participated in this project supplied their machine-readable files to an HCFA
contractor, and those files were translated into a single common format. The
States from which Medicaid data were obtained for this study are California,
Georgia, and Michigan. Private market data were obtained from United Health
Care (UHC), an organization that directs and/or maintains data for managed care
plans in a number of States. The review of these data and methods was
successful in that generally consistent estimates were computed from each of
the four jurisdictions. Further, there were no bizarre variations with respect
to age, race, or sex. Unanticipated results and glitches in some areas might be
resolved with further examination.
FEDERAL CONTACT OFFICE: Office of Program
Planning and Evaluation
PERSONS: Wilma Johnson, Nancy Cheal
PHONE NUMBER: 404/639-3453
PIC NUMBER: 5802
PERFORMER ORGANIZATION: Battelle, Arlington,
VA
P.I.: Ruth E. Brown, M.S.
TITLE: Evaluation of CDC
and ATSDR Training Activities
ABSTRACT NUMBER: 012
ABSTRACT: As local health departments face fiscal
upheavals, this study assessed their current and emerging training needs
through focus groups and site visits. Training needs were compared with a newly
developed inventory of training activities offered by CDC. Local health
programs were found to need training in advocacy, evaluation, and public
information. They were found to be deficient at training needs assessment, a
formal way of identifying and monitoring the skills employees need to do their
jobs better or to attain their career goals. CDC, which itself has limited
training resources, is found to have no periodic mechanisms for staying in
touch with State and local training needs. Recommendations, including those for
new training technology (i.e., interactive software and satellite
communications), are galvanizing CDC and ATSDR to develop training activities
that dovetail with local needs.
FEDERAL CONTACT OFFICE: Public Health Practice
Program Office
PERSON: Dennis McDowell
PHONE NUMBER: 404/639-3707
PIC NUMBER: 4745
PERFORMER ORGANIZATION: Macro Systems
International, Atlanta, GA
P.I.: Thomas Chapel
TITLE: Evaluation of
National Health Interview Survey Diagnostic Reporting
ABSTRACT NUMBER: 013
ABSTRACT: The purpose of this project was to
evaluate diagnostic reporting in the National Health Interview Survey, which
addressed major current health issues through the collection and analysis of
national data on the civilian noninstitutionalized population of the United
States. The survey provides national data on the incidence of acute conditions
and injuries, the prevalence of chronic conditions and impairments, the extent
of disability, and the use of health care services. The basic design of the
evaluation study involved a comparison of information obtained from respondents
to the basic health questionnaire, minimally modified, with reports obtained
from the respondents' sources of health care. The primary objectives were to
determine whether medical record documentation confirmed respondents' reports
about selected conditions and impairments, to determine whether conditions
mentioned in the record were mentioned by respondents, to assess the reporting
and timing of doctor visits and hospitalizations, and to evaluate the validity
of proxy reports to items in the questionnaire. The condition-related
objectives are addressed in this final report; utilization data are addressed
in an auxiliary report.
FEDERAL CONTACT OFFICE: Office of Program
Planning and Evaluation
PERSONS: Wilma Johnson, Nancy Cheal
PHONE NUMBER: 404/639-3453
PIC NUMBER: 3199
PERFORMER ORGANIZATION: National Center for
Health Statistics, Hyattsville, MD
P.I.: Deborah M. Winn
TITLE: Evaluation of
Sexually Transmitted Disease Clinic Flow and Utilization
ABSTRACT NUMBER: 014
ABSTRACT: This study sought to study
overburdening among sexually transmitted disease (STD) clinics in metropolitan
areas with high STD morbidity. It assessed the impact of challenges to STD
service delivery that developed in the late 1980s and early 1990s, including
increasing incidence rates for STDs, addition of HIV services, retrenchment of
funding, and more elaborate patient testing. These factors led to an inability
in many clinics to see all clients who present for STD testing and/or treatment
on a given day. The study sought to examine the effectiveness of STD clinics in
providing services to those who seek care in the clinic and to clarify the
factors that lead to overburdening.
FEDERAL CONTACT OFFICE: Office of Program
Planning and Evaluation
PERSONS: Wilma Johnson, Nancy Cheal
PHONE NUMBER: 404/639-3453
PIC NUMBER: 4164
PERFORMER ORGANIZATION: Battelle, Arlington,
VA
P.I.: Martha L. Hare, Ph.D.
TITLE: Evaluation of the
Morbidity and Mortality Weekly Report Series
ABSTRACT NUMBER: 015
ABSTRACT: The Morbidity and Mortality Weekly
Report (MMWR) is a principal means by which CDC communicates key
information on a timely basis to the public health community. In recent years,
the scope of the MMWR has broadened, reflecting the larger mission of
CDC. This study sought to learn how well the MMWR is communicating
information to this broader public health audience while continuing to convey
timely information about outbreaks and infectious diseases. A mail/-telephone
readership survey was given to 375 individuals on the MMWR mailing
list, 375 subscribers to the MMWR through the Massachusetts Medical
Society, and 250 primary care physicians who subscribe to the Journal of
the American Medical Association (in which articles from the MMWR
are reprinted). The study characterized selected audiences for the
MMWR series, examined the public health impact of information
published in the MMWR, and identified opportunities for improving the
dissemination of public health information contained in the MMWR
series. The study found that the MMWR was valued for its accuracy,
relevance, and concise reporting format. Readers were from diverse professional
backgrounds. The number of readers is likely double the 450,000 on mailing
lists. Recommendations may result in some refinements to content and
format.
FEDERAL CONTACT OFFICE: Epidemiology Program
Office
PERSON: Richard A. Goodman, M.D., M.P.H.
PHONE NUMBER: 404/639-3636
PIC NUMBER: 5357
PERFORMER ORGANIZATION: Battelle, Arlington,
VA
P.I.: James O. Hersey, Ph.D.
TITLE: Lessons From
Implementing State-Based Diabetes Control Programs: An Evaluation
ABSTRACT NUMBER: 016
ABSTRACT: The purpose of this project was to
assess the effectiveness and identify exemplary practices of State-based
diabetes control programs (DCPs) in providing services with the potential of
reducing diabetes-related mortality and morbidity. Intensive site visits to 9
of the 27 DCPs were conducted. The study analyzed archival data and interviews
with DCP and non-DCP personnel in State and local programs. The study looked
for exemplary practices associated with four outcomes: program reach--the
number of persons screened, counseled, referred, and treated as the result of
DCP activities; system change in terms of improved coverage for diabetes
services and increased numbers of clinics and providers offering diabetes
services; integration of diabetes services into ongoing medical service
delivery; and leveraging resources for and institutionalization of diabetes
programs. Findings indicated that DCPs have had measurable impact on diabetes
services. Specific program accomplishments are cited, as are recommendations
for program expansion and refinement.
FEDERAL CONTACT OFFICE: Office of Program
Planning and Evaluation
PERSONS: Wilma Johnson, Nancy Cheal
PHONE NUMBER: 404/639-3453
PIC NUMBER: 5299
PERFORMER ORGANIZATION: Battelle, Arlington,
VA
P.I.: James O. Hersey, Ph.D.
TITLE: Report of the
Working Group To Revise the Model State Vital Statistics Act and
Regulations
ABSTRACT NUMBER: 017
ABSTRACT: The purpose of this project was to
determine what revisions were needed in the Model State Vital Statistics Act
and Regulations to accommodate changes in social customs and technology
relative to the registration of vital events and the analysis of vital
statistics data. A group of consultants representing State vital registration
and statistics executives advised the contractor as to what changes were
necessary.
FEDERAL CONTACT OFFICE: Office of Program
Planning and Evaluation
PERSONS: Wilma Johnson, Nancy Cheal
PHONE NUMBER: 404/639-3453
PIC NUMBER: 4065
PERFORMER ORGANIZATION: Pace Enterprises, Inc.,
Atlanta, GA
TITLE: Vital Records
Evaluation Using 1988 National Maternal and Infant Health Survey
Data
ABSTRACT NUMBER: 018
ABSTRACT: The purpose of this study was to
compare selected data elements reported in the 1988 National Maternal and
Infant Health Survey (NMIHS) with information contained in the original vital
records, maintained by the States, covering the same set of birth events and/or
fetal deaths. More than 3,200 live birth certificates and more than 4,500 fetal
death reports were compared with data from the 1988 NMIHS. The quality and
completeness of the information reported in the vital record was assessed,
discrepancies with respect to the NMIHS identified, and the nature and
frequency of the discrepancies examined. The four components of the study were
(1) the check box items in the new birth and fetal death certificate; (2)
underlying cause of fetal death; (3) industry and occupation; and (4) multiple
causes of death. Of the check box items, medical risk factors, obstetric
procedures, complications of labor and delivery, method of delivery, and
newborn abnormalities were studied. Among the data sources, maternal alcohol
and tobacco use and prenatal weight gain were compared.
FEDERAL CONTACT OFFICE: Office of Program
Planning and Evaluation
PERSONS: Wilma Johnson, Nancy Cheal
PHONE NUMBER: 404/639-3453
PIC NUMBER: 4067
PERFORMER ORGANIZATION: JWK Inter-national
Corporation, Annandale, VA
Food and Drug Administration
Listing of Abstract Titles
Evaluation of Influenza Virus Vaccine in High Risk Infection
Categories
Increasing the Safety of the Blood Supply by Screening Donors More
Effectively
TITLE: Evaluation of Influenza Virus Vaccine
in High Risk Infection Categories
ABSTRACT NUMBER: 019
ABSTRACT: The objective of this study was to
ensure the continued protection of the public from the influenza virus through
ongoing investigation into the reactogenicity, immunogenicity, and protective
efficiency of split product and whole virus influenza vaccines and other
vaccines that are commercially available or being considered for licensure.
Information from the study is helping scientific reviewers assess current
vaccines, while providing guidance to developing vaccines for licensure in the
Center for Biologics Evaluation and Research. The sera obtained during this
study are being used to provide standard sets of sera so that results from
different national and international reference laboratories can verify
comparability of results. The studies in infants are reproduced by no other
source and serve as an important reference resource.
FEDERAL CONTACT OFFICE: Office of Program
Planning and Evaluation
PERSON: Tim Hagerty
PHONE NUMBER: 301/443-4076
PIC NUMBER: 4355
PERFORMER ORGANIZATION: Hackensack Medical
Center, Hackensack, NJ
P.I.: Peter Gross
TITLE: Increasing the
Safety of the Blood Supply by Screening Donors More Effectively
ABSTRACT NUMBER: 020
ABSTRACT: The goal of the study was to improve
the blood donation process by integrating and simplifying all information
(particularly HIV/AIDS-related information) presented to donors. The study
evaluated mechanisms for blood donor education that address the needs of
first-time donors and blood center staff. The study findings are helping the
Center for Biologics Evaluation and Research staff screen out unsuitable donors
and motivate healthy ones to donate more frequently. As a result of this study,
a new donor screening process and a training program for health screeners were
developed.
FEDERAL CONTACT OFFICE: Office of Program
Planning and Evaluation
PERSON: Tim Hagerty
PHONE NUMBER: 301/443-4076
PIC NUMBER: 5685
PERFORMER ORGANIZATION: American Institutes for
Research, Washington, DC
Health Resources and Services Administration
Listing of Abstract Titles
Evaluation Design: Evaluation of the Effectiveness of Community
Health Centers
Linkage Programs: Survey of Mental Health Services
Perinatal Pilot-Test Summary and Implementation Report
HIV Service Networks in Four Rural Areas
Implementation of Title I of the Ryan White CARE Act of 1990
The Participation of People With HIV in Title I HIV Health Services
Planning Councils
Evaluation of Methods for Estimating Unit Costs of HIV Health and
Support Services
Rural Health Travels the Telecommunica-tions Highway--Reaching
Rural
The Demographic and Treatment Characteristics of the Hill-Burton
Population
Survey of Beneficiaries of Nursing Education Projects
The Training and Practice of Preventive Medicine Specialists: An
Underutilized Resource
Evaluation of Bureau of Health Professions Strategic Directions--Phase
I
TITLE: Evaluation Design: Evaluation of the
Effectiveness of Community Health Centers
ABSTRACT NUMBER: 021
ABSTRACT: The purpose of this joint HRSA/OASH
project was to develop a study design that would examine the efficiency and
effectiveness of community and migrant health centers (C/MHCs); the centers'
impact on the health status of their users; and ways in which the centers can
improve their performance. Comparison of costs, utilization, and health
outcomes for similar populations not using C/MHCs are part of the design.
Issues of how and when various outcomes are reported, how data concerning them
can be gathered, and whether the specified outcome measures are appropriate for
evaluation were studied. The report calls for analysis of approximately 50
community health centers (CHCs) in 10 States. The report recommends that
effectiveness and impact of the CHC model(s) be assessed by describing the
characteristics of the CHC delivery model(s); measuring the impact of the
model(s) on use of health services, health care expenditures, and indicators of
health status; and identifying factors that contribute to the observed impact.
The design formed the basis for an evaluation of the centers that began in
September 1994.
FEDERAL CONTACT OFFICE: Division of Community and
Migrant Health, Bureau of Primary Health Care
PERSON: Judy Rodgers
PHONE NUMBER: 301/594-4340
PIC NUMBER: 4918
PERFORMER ORGANIZATION: Lewin/VHI, Inc., Fairfax,
VA
P.I.: Ann Zuvekas
TITLE: Linkage Programs:
Survey of Mental Health Services
ABSTRACT NUMBER: 022
ABSTRACT: In 1989, HRSA's Bureau of Primary
Health Care and the National Institute on Drug Abuse cosponsored the Integrated
Primary Care and Substance Abuse Treatment Program, referred to as the "Linkage
Program," a multiyear demonstration program supporting 21 community-based
approaches for linking substance abuse and primary care services. This
demonstration led to recognition of the need for mental health services in
these linkage projects. A survey was designed to examine various delivery
system features pertaining to availability, scope, and delivery of mental
health services, and barriers to providing these services. The 15 projects that
received fourth-year continuation grants (which included seven community health
centers) were the focus of this study. The major finding was that most linkage
projects evolved a supportive environment for assessment of mental health
problems and a system of referral to and delivery of mental health services.
However, projected need for mental health services outstripped delivery system
capacity. Findings from this study will help other providers of primary care
services establish the necessary alliances and treatment networks to reduce
delivery system fragmentation and develop a continuum of inpatient and
ambulatory mental health services.
FEDERAL CONTACT OFFICE: Division of Programs for
Special Populations, Bureau of Primary Health Care
PERSON: Thomas M. Coughlin
PHONE NUMBER: 301/594-4450
PIC NUMBER: 3557.2
PERFORMER ORGANIZATION: MDS Associates, Inc.,
Wheaton, MD
P.I.: Marilyn Falik, Ph.D.
TITLE: Perinatal
Pilot-Test Summary and Implementation Report
ABSTRACT NUMBER: 023
ABSTRACT: The purpose of this study was to
develop and pilot test a patient-specific data collection tool for perinatal
patients and infants receiving services in Community and Migrant Health Centers
(C/MHCs) funded by HRSA's Bureau of Primary Health Care (BPHC) and to prepare a
plan for implementing this tool. This study is part of an effort to develop and
implement a BPHC-wide data and evaluation strategy to improve the availability
of information about patients served by grantees. Two patient-specific forms
were designed to capture information regarding specific process and outcomes
measures. The first would collect data about pregnant women using prenatal
and/or postpartum services in C/MHCs, and the second would collect data on
infants age 12 months or younger whether or not their mothers used prenatal or
postpartum services in a C/MHC. A pilot test was conducted in eight centers
over 5 months, and feedback was collected from 22 additional centers via
telephone interviews. The pilot test provided information about the data
collection instruments with regard to availability of the requested data and
completeness and reliability of the data collected, and identified the need to
revise the data items, definitions, instructions, and formats. The study found
that universal adoption of the forms would be burdensome and expensive. It
recommends instead that the form be used in a study of 4,000 mother-child pairs
at about 20 C/MHC sites over a 4-year period.
FEDERAL CONTACT OFFICE: Division of Programs for
Special Populations, Bureau of Primary Health Care
PERSON: Thomas M. Coughlin
PHONE NUMBER: 301/594-4450
PIC NUMBER: 4208.1
PERFORMER ORGANIZATION: Lewin/VHI, Inc., Fairfax,
VA
P.I.: Ann Zuvekas
TITLE: HIV Service
Networks in Four Rural Areas
ABSTRACT NUMBER: 024
ABSTRACT: The purpose of this study was to
identify and describe systems of HIV care in four rural areas. The study was
designed to build understanding of how HIV services are being organized and
delivered in different rural environments and to identify service gaps and
barriers to care. The case studies identified two distinct approaches to
providing medical care to rural residents with HIV: (1) an HIV clinic, located
in a rural health department or community health center, that develops
cooperative working agreements with physicians in private practice and (2) care
provided by primary care physicians who are linked with a medical school or
rural-based regional care facility for training and backup consultation. The
case studies also documented the need to place more emphasis on HIV training
and education in rural areas to create more positive environments for the
development of medical and support services. The study's findings and
recommendations are being used to design a national study of HIV care in rural
areas that will be funded by HRSA. This rural study will be integrated with a
large national study of HIV costs and service utilization that is being
sponsored by the Agency for Health Care Policy and Research. Case study
findings also are being used to formulate HRSA polices on rural HIV care and to
provide technical assistance to States with large rural populations.
FEDERAL CONTACT OFFICE: Office of Science and
Epidemiology, Bureau of Health Resources Development
PERSON: Katherine Marconi, Ph.D.
PHONE NUMBER: 301/443-6560
PIC NUMBER: 5642
PERFORMER ORGANIZATION: David Berry Company, Las
Vegas, NV
P.I.: David Berry
TITLE: Implementation of
Title I of the Ryan White CARE Act of 1990
ABSTRACT NUMBER: 025
ABSTRACT: This project measured the extent to
which five policy objectives of Title I of the Ryan White CARE Act were
achieved in Baltimore, MD, and Oakland, CA: (1) local control and definition of
priority setting for the allocation of funds to community AIDS service
organizations; (2) rapid disbursement of funds; (3) increased access to
services by expanding existing services and adding new agencies; (4) improved
coordination of HIV-related services; and (5) increased access to HIV services
for underserved populations. To measure progress toward these objectives,
surveys were conducted of all identified AIDS services providers and nonrandom
samples of people with HIV in 1991 and 1993 in Baltimore and Oakland.
Additionally, case studies of the Title I Planning Council processes in each
city were completed. All policy objectives, with the exception of improved
coordination among services, were met, and a series of recommendations was made
for the future administration of this Act. The Henry J. Kaiser Family
Foundation funded the 1993 surveys. (The report also presents planning council
studies conducted in four eligible metropolitan areas that were not part of the
HRSA baseline study.)
FEDERAL CONTACT OFFICE: Office of Science and
Epidemiology, Bureau of Health Resources Development
PERSON: Moses B. Pounds
PHONE NUMBER: 301/443-6560
PIC NUMBER: 5639
PERFORMER ORGANIZATION: Johns Hopkins University,
Baltimore, MD
P.I.: David D. Celentano, Sc.D.
TITLE: The Participation
of People With HIV in Title I HIV Health Services Planning
Councils
ABSTRACT NUMBER: 026
ABSTRACT: Ryan White CARE Act Title I Health
Services Planning Councils are required by statute to include membership from
"affected communities, including individuals with HIV disease." Experience has
indicated, however, that eliciting and sustaining participation by these
individuals is one of the major challenges facing councils. This study was
conducted to identify factors supporting the initial and sustained involvement
of HIV-positive individuals in the councils, and identify alternative methods
employed by the councils to gain input from and provide feedback to
HIV-positive populations in the absence of direct participation. In-depth
discussions and focus groups were held in Atlanta, Philadelphia, San Diego, and
Seattle, with a total of 113 participants, 90 of whom were HIV-positive. The
study found that the councils have undergone an evolution with regard to how
they recruit HIV-positive members and whom they recruit: all councils now
express commitment to recruiting HIV-positive members of greater ethnic and
gender diversity. All councils reported using numerous mechanisms for obtaining
input from HIV-positive nonmembers, including public forums, client needs
surveys, and participation in advocacy groups. Based on the study report, the
Division of HIV Services has issued a policy statement on council
membership.
FEDERAL CONTACT OFFICE: Division of HIV Services,
Bureau of Health Resources Development
PERSON: Steven R. Young
PHONE NUMBER: 301/443-9091
PIC NUMBER: 5643
PERFORMER ORGANIZATION: Academy for Educational
Development, Washington, DC
TITLE: Evaluation of Methods for Estimating
Unit Costs of HIV Health and Support Services
ABSTRACT NUMBER: 027
ABSTRACT: The purpose of this study was to
evaluate the procedures used to estimate costs of providing health and social
services to people with HIV infection. This study compared two methods of
costing Ryan White CARE Act services. The first method used an average unit
cost approach: total program budgets are divided by total number of service
units to yield an average unit cost. The results indicate a wide variation in
costs, as a result of actual variations in the content, quality, and volume of
services provided, as well as some reporting and methodological errors. The
second methodology used a direct cost profile approach to construct the cost of
one standard unit of service. This method was tested among a selected group of
five Texas CARE Act providers using a questionnaire. This method proved
difficult to administer and less accurate than the average unit cost method,
although some cost estimates are provided. The study concluded that the average
unit cost method is more intuitive and straightforward for CARE Act providers,
primarily because most providers use program budgets. A manual for estimating
the unit costs of HIV care is now available to Ryan White CARE Act
grantees.
FEDERAL CONTACT OFFICE: Office of Science and
Epidemiology, Bureau of Health Resources Development
PERSON: Christine Hager
PHONE NUMBER: 301/443-6560
PIC NUMBER: 5640
PERFORMER ORGANIZATION: Texas Department of
Health, Austin, TX
P.I.: Susan Griffin
TITLE: Rural Health
Travels the Telecommunications Highway--Reaching Rural
ABSTRACT NUMBER: 028
ABSTRACT: The Health Resources and Services
Administration sponsored a workshop in November 1993, in Washington, DC, to
consider the use of telecommunications technology for providing medical care to
rural patients and for reducing the isolation of rural health professionals.
The workshop was intended to address the application of telecommunications to
clinical care (telemedicine) and to the education of health professionals
(distance learning). The purpose of the workshop was to discuss policy issues
that affect the development and appropriate use of telemedicine systems. The
workshop included descriptions of operating telemedicine systems and the
problems they have had to overcome. Workshop participants also provided advice
for future telemedicine evaluations. A number of commissioned papers identified
and assessed barriers and opportunities for applying this technology in rural
areas. The workshop provided an opportunity to develop consensus in order to
advance the effective use of this technology in rural areas. In addition, the
workshop contributed to the development of the Rural Telemedicine Grant Program
and of an exploratory evaluation of the program that began in September 1994.
The workshop also strengthened collaborative relationships with staff of other
Federal Agencies, such as HCFA and the Departments of Agriculture and Commerce,
that are funding telemedicine projects.
FEDERAL CONTACT OFFICE: Office of Rural Health
Policy
PERSON: Carole L. Minzter
PHONE NUMBER: 301/443-0835
PIC NUMBER: 5644
PERFORMER ORGANIZATION: Ryan-McGinn, Arlington,
VA
P.I.: Teri Randall
TITLE: The Demographic
and Treatment Characteristics of the Hill-Burton Population
ABSTRACT NUMBER: 029
ABSTRACT: The purpose of this study was to
determine the demographic characteristics of the population receiving medical
services under the Hill-Burton Uncompensated Services Program and the
conditions for which treatment was required. These characteristics and
conditions were compared with those of the general population. Data were
obtained from both Hill-Burton records and patient medical records at each of
the 50 facilities selected for participation in the study. Records for 4,835
patients were examined. Specific Diagnostic Related Groups and International
Classification of Disease Codes were obtained for each record. The findings
indicated that, compared with the total U.S. population, the study population
was more likely to be female, young adult, and unmarried, with very low
household income. The study population required services classified as injury,
obstetrical, and ill-defined conditions more often than the general population.
Patient records showed that 69.4 percent had no health insurance and 80.1
percent had no coverage for the services received.
FEDERAL CONTACT OFFICE: Office of Facilities
Compliance, Bureau of Health Resources Development
PERSON: Jacob E. Tenenbaum
PHONE NUMBER: 301/443-4303
PIC NUMBER: 5641
PERFORMER ORGANIZATION: Arthur Testoff Company,
New Carrollton, MD
P.I.: Arthur Testoff
TITLE: Survey of
Beneficiaries of Nursing Education Projects
ABSTRACT NUMBER: 030
ABSTRACT: The purpose of this study was to
evaluate the programs carried out under Title VIII of the Public Health Service
Act and to prepare the biennial report to Congress mandated by Section 859(b)
of the Act. The six programs evaluated were Nursing Special Projects Grants and
Contracts, Nursing Education Opportunities for Individuals From Disadvantaged
Backgrounds Program Grants, Grants for Advanced Nurse Education, Nurse
Practitioner and Nurse-Midwifery Program Grants, Professional Nurse
Traineeships, and Nurse Anesthetist Traineeships. Separate surveys of grantees
and graduates were conducted. The overriding conclusion of this study is that
the Title VIII programs are meeting the purposes they were designed to
accomplish. Federal support has stimulated the development of projects that
address significant nursing education and practice issues. Moreover, the funds
provided for the development of educational programs for advanced practice
nurses and for the support of students are creating a stable resource of
advanced practice nurses.
FEDERAL CONTACT OFFICE: Division of Nursing,
Bureau of Health Professions
PERSON: Evelyn B. Moses
PHONE NUMBER: 301/443-6315
PIC NUMBER: 4433
PERFORMER ORGANIZATION: Washington Consulting
Group, Washington, DC
P.I.: Cyrus Baghelai
TITLE: The Training and
Practice of Preventive Medicine Specialists: An Underutilized
Resource
ABSTRACT NUMBER: 031
ABSTRACT: This project was designed to provide
detailed information through case studies on the practice profile of residents
in selected preventive medicine residency (PMR) programs funded by HRSA. The
study examined the recruitment of residents during their training, the various
mechanisms used to finance the training of residents, and the career options
available to graduates of PMR programs. The study involved the appointment of
an expert working committee whose members conducted site visits to 10
preventive medicine residency programs. The culmination of the project was a
3-day workshop held in Washington, DC, in August 1993, which brought together
PMR program directors with the major constituencies for preventive medicine.
Workshop recommendations included "marketing" preventive medicine to medical
students, developing a national strategy for incorporating preventive medicine
into the standard medical school curriculum, and reassessing the fourth year of
the preventive residency program.
FEDERAL CONTACT OFFICE: Division of Associated,
Dental, and Public Health Professions, Bureau of Health Professions
PERSON: Ronald B. Merrill
PHONE NUMBER: 301/443-6896
PIC NUMBER: 4911
PERFORMER ORGANIZATION: American College of
Preventive Medicine, Washington, DC
P.I.: Hazel K. Keimowitz
TITLE: Evaluation of
Bureau of Health Professions Strategic Directions--Phase I
ABSTRACT NUMBER: 032
ABSTRACT: This study is Phase I of an effort to
develop a fully integrated, computerized data system to facilitate program
effectiveness evaluation and data analysis of Titles VII and VIII programs
administered by the Bureau of Health Professions (BHPr). The purpose of Phase I
was to develop a set of outcome indicators to evaluate the effectiveness of
programs in the context of BHPr's strategic directions and to identify
potential data sources and gaps related to these indicators. Phase II will
solicit external customer input on the proposed set of indicators developed in
Phase I and identify strategies to address data gaps. A third phase may be
needed to develop a consolidated data system for assessing progress toward
achieving strategic program objectives bureauwide.
FEDERAL CONTACT OFFICE: Office of Research and
Planning, Bureau of Health Professions
PERSON: Betty B. Hambleton
PHONE NUMBER: 301/443-1590
PIC NUMBER: 5497
PERFORMER ORGANIZATION: Lewin/VHI, Inc., Fairfax,
VA
P.I.: Susanna Ginsburg
Indian Health Service
Listing of Abstract Titles
An Assessment of Emergency Medical Services
Evaluation of Home Care Services in the Aberdeen Area
Evaluation of Maternal and Child Health Data
Health Promotion and Aging: Improving the Understanding of Geriatric
Patients Related to Medications and Their Proper Use
IHS Indirect Cost Study
Intervention Study To Influence Healthier Lifestyles Among Young
Adolescent Navajo Indians
Long Term Health Projections for Alcohol Abuse-Related
Hospitalizations
Report to Congress on the Indian Health Service With Regard to Health
Status and Health Care Needs of American Indians in California in Response to
Public Law 100-713
Use of an Alternate Model of Nursing Documentation To Increase
Efficiency and Effectiveness of Patient Care Charting
TITLE: An Assessment of Emergency Medical
Services
ABSTRACT NUMBER: 033
ABSTRACT: This project evaluated the Emergency
Medical Service (EMS) program activities of the Indian Health Service (IHS) at
national, area, and service unit levels. The project assessed how well the IHS
EMS services are meeting national and applicable State standards. It identified
strengths of the existing program as well as areas needing improvement. Because
the same methodology has been and is being consistently applied in communities
and States throughout the United States, the IHS assessment provided a useful
comparison of the IHS program with those of the States. The project provided
information on how EMS provided to reservation populations compared with EMS
available to non-Indian rural communities. The end product is a report
representing the consensus of review team members and contains detailed
assessments in each of 10 specific areas. The report provides a basis on which
to recommend improvements to the EMSs to meet the needs of the American Indian
and Alaska Native communities.
FEDERAL CONTACT OFFICE: Office of Planning,
Evaluation, and Legislation
PERSONS: Leo Nolan, Linda Arviso-Miller
PHONE NUMBER: 301/443-0416
PIC NUMBER: 5549
PERFORMER ORGANIZATION: Division of Medical
Systems Research & Development, Tucson, AZ
P.I.: Peter G. Decker
TITLE: Evaluation of Home
Care Services in the Aberdeen Area
ABSTRACT NUMBER: 034
ABSTRACT: This project explored issues related to
home health care services in the Aberdeen [SD] Area as an alternative to
hospital care and an adjunct to all other existing clinical services. The
project evaluated needs as well as home care services provided by the IHS and
others within the IHS system in the Aberdeen Area. The project relates to the
range, quality, and appropriateness of curative and preventive services as well
as broader financial and reimbursement issues. The purpose of the study was to
explore the dimension of needs and the scope of existing community-based
services to a specific population in the Aberdeen Area, specifically American
Indians who currently receive or who would benefit from home care services.
This included indivi-duals of all ages and with all types of health problems.
With growing concern for cost containment and implementation of a prospective
payment system, the health care industry has changed dramatically in the last 4
years. The health care literature is replete with analyses of the expansion in
home care services and problems resulting from patients being discharged
"quicker and sicker." These changes, coupled with technological advances, have
increased the needs and demands for home care services and the types,
complexity, and volume of services delivered nationally.
FEDERAL CONTACT OFFICE: Office of Planning,
Evaluation, and Legislation
PERSONS: Leo Nolan, Linda Arviso-Miller
PHONE NUMBER: 301/443-0416
PIC NUMBER: 5000
PERFORMER ORGANIZATION: American Indian Health
Care Association, St. Paul, MN
P.I.: Carol M. Baines
TITLE: Evaluation of
Maternal and Child Health Data
ABSTRACT NUMBER: 035
ABSTRACT: The purpose of this evaluation,
conducted in two parts, was to assess the availability, utilization, and
quality of the Navajo Area Indian Health Service's data sets in maternal and
child health (MCH). Part 1 was an assessment of the process of data collection
and the perceived data needs. Interviews were conducted with service unit
staff, affiliated tribal programs, IHS personnel specializing in data
collection, Headquarters West, and IHS Headquarters in Rockville, among others.
Findings included the following: the current MCH database does not meet the
needs of clinical staff; researchers compiled a list of specific data
requirements for a broad range of health parameters; there is a downward trend
in multidisciplinary MCH teamwork; area offices emphasize management and
finance rather than population-based health; there is no community--oriented
health approach among the majority of health professions and service unit
administrators; and infant and child health have become fragmented into
specific pediatric initiatives. Part 2 was an assessment of the quality of an
MCH data set through a comparison between computerized entries into delivery
room logs and actual patient records. The congruity was high, with the
exception of data on "planned pregnancies" and "anemia," supporting the
validity and importance of continued integration of 15 or so most important
variables into the Resource and Patient Management System. Findings are
expected to increase the availability of the data to physicians and midwives
nationally.
FEDERAL CONTACT OFFICE: Office of Planning,
Evaluation, and Legislation
PERSONS: Leo Nolan, Linda Arviso-Miller
PHONE NUMBER: 301/443-0416
PIC NUMBER: 5544
PERFORMER ORGANIZATION: Maternal and Child Health
Program, Billings, MT
P.I.: Diane Jeanotte, R.N.
TITLE: Health Promotion
and Aging: Improving the Understanding of Geriatric Patients Related to
Medications and Their Proper Use
ABSTRACT NUMBER: 036
ABSTRACT: This project surveyed Navajo patients'
use of medications at the Chinle Service Unit and assessed the general level of
patient understanding of medications. It also evaluated the effectiveness of
using interactive video technology for non-English-speaking patients and those
with limited English ability. Study recommendations will be helpful in
assessing and improving Navajo geriatric health care. It was determined that
the program for diabetic information was limited. The hardware video was bulky,
ran too long, and was not practical for the major population with limited
English abilities. There were no recommendations for use at other clinics in
the IHS.
FEDERAL CONTACT OFFICE: Office of Planning,
Evaluation, and Legislation
PERSONS: Leo Nolan, Linda Arviso-Miller
PHONE NUMBER: 301/443-0416
PIC NUMBER: 5006
PERFORMER ORGANIZATION: Headquarters East IHS,
Rockville, MD
P.I.: Viola Dwight
TITLE: IHS Indirect Cost
Study
ABSTRACT NUMBER: 037
ABSTRACT: This study determined the dollar amount
of all IHS overhead costs, where and how money was spent, and how it was linked
to the provision of direct health care. These goals were accomplished through
interviews, research, and analysis of financial data. Interviews were conducted
throughout the IHS organization. Interview information was compared with
financial data to distinguish between overhead and direct health care.
Functional analyses and cost center analyses were performed. Overhead costs for
FY 1992 were calculated at 19.1 percent. Because some cost centers commingled
direct and overhead costs, data obtained from individual cost centers were
difficult to segregate and quantify. Cost accounting procedures were found not
to be uniformly applied within IHS. Such inconsistency made it difficult to
compare overhead costs among Area offices. The study proposed a refined cost
center design that carefully distinguishes between overhead and direct care
costs. It also offered recommendations, including timely reviews of cost center
expenditures.
FEDERAL CONTACT OFFICE: Office of Planning,
Evaluation, and Legislation
PERSONS: Leo Nolan, Linda Arviso-Miller
PHONE NUMBER: 301/443-0416
PIC NUMBER: 5552
PERFORMER ORGANIZATION: Native American
Consultants, Inc., Washington, DC
P.I.: Joseph Tinneman
TITLE: Intervention
Study To Influence Healthier Lifestyles Among Young Adolescent Navajo
Indians
ABSTRACT NUMBER: 038
ABSTRACT: Approximately 1,200 seventh and eighth
grade students from three junior high schools were studied for 2 school years,
1991 to 1993. Heights, weights, and a brief behavioral survey were recorded
during the fall and spring of each year. At the intervention school,
certificates for specific nutrition or fitness activities were completed by
students and parents and collected by homeroom teachers. Homerooms competed for
monetary prizes to be used for educational activities. The results for students
at the intervention school were compared with those for students at the control
school. A number of problems arose, some of which could be avoided in the
future and some of which are intrinsic to this type of research. Teachers,
administrators, parents, and students often had other commitments with higher
priority, such as academic classes, exams, and athletics. Although students may
have been willing to participate, some were reluctant to do something different
from their peers, especially if their peers did not think it was "cool" to
participate in the fitness-nutrition program. The number of students willing to
participate was initially small and often inconsistent in followup responses.
Distances between participating schools was great and made it difficult to
achieve an impact on the students. Self-reported data, which are known from
many studies to be fraught with problems, were not reliable enough to be
generalizable.
FEDERAL CONTACT OFFICE: Office of Planning,
Evaluation, and Legislation
PERSONS: Leo Nolan, Linda Arviso-Miller
PHONE NUMBER: 301/443-0416
PIC NUMBER: 5026
PERFORMER ORGANIZATION: Navajo Area IHS, Chinle,
AZ
P.I.: Park W. Gloyd
TITLE: Long Term Health
Projections for Alcohol Abuse-Related Hospitalizations
ABSTRACT NUMBER: 039
ABSTRACT: This study made long-term pro-jections
for a specific disease and/or health category to determine (1) if current
health and mortality patterns will continue without further scientific,
treatment, or behavioral improvements and (2) the number of American Indians
and Alaska Natives who will become ill or die from a specifically identified
condition over the next 25 years. The study included an estimate of
contributions expected from advances and innovations in current treatment and
technology and changes in societal behavioral patterns, and evaluated how these
contributions affected existing mortality rates and savings from eliminating
medical costs and lost productivity. The study did reveal a decline in alcohol
abuse; however, it was not as significant as it should have been. In fact,
alcohol abuse may be worsening for women ages 55-64. Findings of the study
include recommending long-term projection models that will give a truer picture
of which intervention methodo-logies are most effective.
FEDERAL CONTACT OFFICE: Office of Planning,
Evaluation, and Legislation
PERSONS: Leo Nolan, Linda Arviso-Miller
PHONE NUMBER: 301/443-0416
PIC NUMBER: 5034
PERFORMER ORGANIZATION: Support Services, Inc.,
Silver Spring, MD
P.I.: Walter Hillabrant, Ph.D.
TITLE: Report to
Congress on the Indian Health Service With Regard to Health Status and Health
Care Needs of American Indians in California in Response to Public Law
100-713
ABSTRACT NUMBER: 040
ABSTRACT: This study documented the health
status and access to health care services of American Indians in California,
especially in tribes that are not federally recognized. Through analysis of
vital statistics and other databases, comparisons were made between California
Indians who are members of federally recognized tribes and those who are not.
On the basis of these and other comparisons, American Indians in non-federally
recognized tribes in California generally had poorer health status than those
in federally recognized tribes. The health status of both groups was inferior
to that of other populations. For example, 6.4 percent of California Indian
babies were low birthweight, whereas 5.2 percent of statewide births were low
birthweight. These and related findings underscored the importance of
maintaining and expanding coverage to the entire American Indian population of
California. This study was coordinated with the California Area Office of the
Bureau of Indian Affairs, the California Health Department, California State
Indian organizations, and clinics.
FEDERAL CONTACT OFFICE: Division of Planning,
Evaluation, and Legislation
PERSON: Leo Nolan
PHONE NUMBER: 301/443-4700
PIC NUMBER: 4955
PERFORMER ORGANIZATION: University of
California, Los Angeles, CA
P.I.: Leila Beckwith
TITLE: Use of an Alternate Model of Nursing
Documentation To Increase Efficiency and Effectiveness of Patient Care
Charting
ABSTRACT NUMBER: 041
ABSTRACT: The purpose of the project was to
evaluate current inpatient nursing documentation at three Billings [MT] Area
hospitals and, at the option of the hospital, to evaluate a new documentation
format. Two of the three hospitals chose to implement FOCUS charting, a new
method that streamlines the process by requiring written notes only for
abnormal patient characteristics. This method was developed by Creative Nursing
Management of Minneapolis, Minnesota. The existing system relied on
documentation of both normal and abnormal characteristics. The specific goals
of FOCUS charting were to (1) improve the quality and content of nursing
documentation; (2) facilitate inclusion of information required by certifying
agencies; (3) decrease charting time; and (4) increase nursing satisfaction.
The third site, Ft. Belknap, opted to keep the existing system because it is a
small facility scheduled for conversion to an outpatient facility in the near
future. The impact of current and new procedures was assessed via two
surveys--a nursing satisfaction survey and a documentation time survey. Chart
reviews were also performed at each site before and after implementation of the
new documentation format. There was overall improvement with FOCUS charting,
although patient education and discharge planning remained problematic.
Regardless of the method, all service units successfully met documentation
standards in an August 1994 survey by the Joint Commission on Accreditation of
Health Care Organizations. The FOCUS chart method was permanently adopted by
one of the hospitals.
FEDERAL CONTACT OFFICE: Office of Planning,
Evaluation, and Legislation
PERSONS: Leo Nolan, Linda Arviso-Miller
PHONE NUMBER: 301/443-0416
PIC NUMBER: 5003
PERFORMER ORGANIZATION: IHS Billings Area
Office, Billings, MT
P.I.: Jaloo Zelonis
National Institutes of Health
Listing of Abstract Titles
Adverse Events Associated With Childhood Vaccines--Evidence Bearing
on Causality
Meeting the Nation's Needs for Biomedical and Behavioral Scientists
Evaluating the Effects of School-Based Intervention Programs To Prevent
Teenager Drug Use and Abuse
Evaluation of NIH-Funded Condom Research Phase I: Evaluability
Assessment
Indoor Allergens--Assessing and Controlling Adverse Health Effects
Outreach/Risk Reduction Strategies for Changing HIV-Related Risk
Behaviors Among Injection Drug Users
Study To Assess the Current and Future Demand for Bone Marrow and the
Impact on Size of the National Marrow Donor Registry
Survey of the Knowledge, Attitudes, and Practices of Physicians Related
to Blood Use, Transfusion, and Donation
TITLE: Adverse Events Associated With
Childhood Vaccines--Evidence Bearing on Causality
ABSTRACT NUMBER: 042
ABSTRACT: This study entailed a broad review of
all relevant medical and scientific literature on the potentially serious risks
associated with currently licensed childhood vaccines. This study was mandated
by Congress under Section 313 of Public Law 99-660 to yield essential
information that would help the Public Health Service draft recommendations on
the use of certain mandated childhood vaccines and appropriate compensation for
adverse reactions. The project was funded by the National Institutes of Health,
the National Vaccine Program, the Centers for Disease Control and Prevention,
and the Health Resources and Services Administration. The final report is a
book, Adverse Events Associated with Childhood Vaccines--Evidence Bearing on
Causality, published by the National Academy Press in 1993. It summarizes the
relevant input from interested organizations and individuals and describes the
nature and extent of the relationship, if any, between the specified adverse
events and the vaccines or vaccine components. In addition, the book describes
the available data on the circumstances under which administration of these
vaccines increases risks of serious or chronic adverse events and on the
definition of any known risk groups for these adverse events.
FEDERAL CONTACT OFFICE: Division of Microbiology
and Infectious Disease, NIAID
PERSON: Regina Rabinovich, M.D.
PHONE NUMBER: 301/496-5893
PIC NUMBER: 4198.1
PERFORMER ORGANIZATION: Institute of Medicine,
National Academy of Sciences, Washington, DC
P.I.: Sylvia Cunningham
TITLE: Meeting the
Nation's Needs for Biomedical and Behavioral Scientists
ABSTRACT NUMBER: 043
ABSTRACT: This report examines the Nation's
future need for biomedical and behavioral research scientists and the role the
National Research Service Awards (NRSA) program can play in meeting them. The
report is based on three activities: (1) a panel on estimation procedures was
established to provide numerical analysis of educational and employment
prospects and of national needs for biomedical and behavioral research
personnel; (2) a public hearing was held to solicit the views of a broad
constituency associated with NRSA programs; and (3) committee meetings were
held to discuss and debate information and recommendations. The committee finds
that the NRSA program, although small, is influential and prestigious. It is
powerful in its ability to change research emphases and to attract the highest
quality individuals to research careers. Furthermore, initiatives introduced
through NRSA can have a powerful impact on new research emphases or
constituencies. The report makes several recommendations, including the
following: (1) raise the real value of stipends to a more competitive level;
(2) maintain the annual number of predoctoral and postdoctoral awards in the
basic biomedical sciences at 1993 levels; (3) increase the number of awards in
the behavioral sciences; and (4) increase the awards in clinical sciences, oral
health research, nursing research, and health services research.
FEDERAL CONTACT OFFICE: Office of the Director,
NIH
PERSON: Walter Schaffer, Ph.D.
PHONE NUMBER: 301/435-2770
PIC NUMBER: 5567
PERFORMER ORGANIZATION: National Academy of
Sciences, Washington, DC
P.I.: National Academy of Sciences
TITLE: Evaluating the
Effects of School-Based Intervention Programs To Prevent Teenager Drug Use and
Abuse
ABSTRACT NUMBER: 044
ABSTRACT: The purpose of this followup study was
to assess the long-term effectiveness of a junior high school-based prevention
program for reducing student drug use and abuse. The intervention was based on
Life Skills Training, an approach that teaches social resistance and other
personal and coping skills. In 1986, schools were randomly assigned to one of
two approaches to teaching Life Skills Training or to a control group (no
training). This followup study was conducted 6 years later to determine the
long-term efficacy of the intervention. The probability of smoking, drinking
immoderately, or using marijuana was significantly lower, by as much as 40
percent, for students who received the intervention programs than for those in
the control group. The study provides the first evidence that school-based
intervention programs conducted by regular classroom teachers can produce
durable reductions in tobacco, alcohol, and illicit drug use. The results
provided empirical support for the efficacy of a school-based prevention
strategy based on a broad-spectrum, cognitive-behavioral approach in prevention
of drug use and abuse. Long-term prevention of effects were found, providing
impetus for the widespread adoption of similarly designed programs.
FEDERAL CONTACT OFFICE: Division of Epidemiology
and Prevention Research, NIDA
PERSON: Larry A. Seitz, Ph.D.
PHONE NUMBER: 301/443-1514
PIC NUMBER: Unassigned
PERFORMER ORGANIZATION: Cornell University
Medical College, New York, NY
P.I.: Gilbert J. Botvin, Ph.D.
TITLE: Evaluation of
NIH-Funded Condom Research Phase I: Evaluability Assessment
ABSTRACT NUMBER: 045
ABSTRACT: The objectives of this evaluation were
to (1) assess the findings of condom use research efforts; (2) guide the
development of future program areas; and (3) suggest methodological guidelines
to facilitate the evaluation of future condom use research programs. This
initial phase was an evaluability assessment to identify and inventory the
universe of condom research studies as well as to determine whether or not a
formal evaluation of past NIH-funded behavioral research on condom use would be
feasible and useful. The results of this evaluability assessment are to be used
by the Technical Advisory Group to decide whether to proceed to subsequent
phases of more intensive evaluation. The conclusions of this activity indicate
that an expanded evaluation is feasible and could provide useful information to
guide the development of future program areas and to facilitate the evaluation
of future condom research programs. A critical feasibility issue for any
research synthesis is the identification of the universe of relevant studies.
The Phase I activity developed a reproducible methodology to create a sampling
frame, established a sampling frame of more than 500 studies, and developed and
applied definitions that permitted sorting studies by key research
characteristics and abstracting relevant information about funded projects. The
final report will be disseminated to NIH Institutes and committees as well as
other organizations or individuals involved in condom use research.
FEDERAL CONTACT OFFICE: Office of Policy
Analysis and Technology Transfer, NIAID
PERSON: Wendy Liffers
PHONE NUMBER: 301/496-6752
PIC NUMBER: 5494
PERFORMER ORGANIZATION: Research Triangle
Institute, Research Triangle Park, NC
P.I.: John W. Tintoul
TITLE: Indoor
Allergens--Assessing and Controlling Adverse Health Effects
ABSTRACT NUMBER: 046
ABSTRACT: The purpose of this study was to
characterize what is known among a broad range of experts whose efforts are
directed toward achieving cleaner indoor environments. The focuses of this
study were to evaluate the indoor environment and to appraise the knowledge
base commonly available to physicians with respect to human exposure to indoor
allergens. A committee of experts was appointed to (1) examine and characterize
what is known about the adverse effects on human health caused by reactions,
including asthma, to indoor allergens; (2) characterize the magnitude of these
problems nationally; (3) define the populations commonly affected; and (4)
identify the specific causative agents. The study reviewed published
epidemiological reports, estimated the economic impact of these diseases, and
determined the risk factors. It examined methods used in patient diagnosis and
measurement of indoor allergen exposures and evaluated methods of abatement and
control of sources of allergens. The study resulted in a book titled Indoor
Allergens: Assessing and Controlling Health Effects. The book pointed out that
indoor allergen exposure is a major risk factor for asthma and that exposure to
indoor allergens may be increasing, in part because of house construction
methods that have made homes "tight" and in part because individuals are
spending more time indoors. The study should raise public perception of the
importance of indoor allergens in the pathogenesis of asthma and allergic
diseases, and provide a framework for a research agenda to relieve the problem
created by indoor allergens. The dissemination of the report should result in
research proposals to pursue the suggestions in the report. In addition, NIAID
intends to use the National Asthma Education Program to further disseminate the
information in the report.
FEDERAL CONTACT OFFICE: Division of Immunology,
Allergy, and Transplantation, NIAID
PERSON: Marshall Plaut, M.D.
PHONE NUMBER: 301/496-8973
PIC NUMBER: 4465
PERFORMER ORGANIZATION: Institute of Medicine,
National Academy of Sciences, Washington, DC
P.I.: Andrew Pope, Ph.D.
TITLE: Outreach/Risk
Reduction Strategies for Changing HIV-Related Risk Behaviors Among Injection
Drug Users
ABSTRACT NUMBER: 047
ABSTRACT: This study evaluates the effectiveness
of outreach programs for reducing HIV-related risk behaviors of injection drug
users (IDUs) and their sexual partners. Under the sponsorship of the National
AIDS Demonstration Research Project, the outreach programs offer information
about HIV infection, strategies for reducing the risk, counseling, support
groups, and training in cognitive and social skills. The programs operated at
28 sites, at which data were collected on 13,475 IDUs and 1,637 sexual partners
of IDUs. Investigators used a before/after design, comparing data at 6-month
followup with those at baseline by using the AIDS Initial Assessment (AIA) and
AIDS Followup Assessment (AFA). Comparison of AIA and AFA data for IDUs and
analysis of interview data revealed that the interventions yielded significant
decreases in HIV-related risk behaviors, especially related to needle use.
Significant increases were found in the use of new rather than reused needles,
bleach for cleaning injection equipment, and condoms--all behaviors that reduce
risk. This study provided evidence that IDUs and their sexual partners can be
reached, can listen to educational strategies to reduce risk, and can change
their HIV-related risk behaviors. Reduction in drug injection frequency and use
of noninjected drugs was especially noteworthy. Study findings led to the
creation of a permanent program.
FEDERAL CONTACT OFFICE: Division of Epidemiology
and Prevention Research, NIDA
PERSON: Richard Needle, Ph.D., M.P.H.
PHONE NUMBER: 301/443-6720
PIC NUMBER: 4655.1
PERFORMER ORGANIZATION: NOVA Research Company,
Bethesda, MD
TITLE: Study To Assess
the Current and Future Demand for Bone Marrow and the Impact on Size of the
National Marrow Donor Registry
ABSTRACT NUMBER: 048
ABSTRACT: The objective of the study was to
estimate the current and future size of the National Marrow Donor Program
(NMDP) Registry. The purpose of the NMDP was to develop and maintain a registry
of volunteer unrelated bone marrow donors; to facilitate bone marrow
transplants by serving as a coordinating and communications center for a
network of donor, collection, and transplant centers in the United States and
internationally; and to facilitate research into the efficacy of unrelated
donor marrow transplants. Bone marrow transplantation is used to treat patients
with chronic myelocytic leukemia, Franconi's anemia, and severe combined immune
deficiency, as well as patients with acute leukemia and lymphoma who have
relapsed following initial therapy. The scope of the program was enlarged in
1992 to increase the number of minority donors in the registry. Strategic
options with financial, cost, and service level implications were developed
that will be used in program management.
FEDERAL CONTACT OFFICE: Office of Program
Planning and Evaluation, NHLBI
PERSON: Barbara Packard
PHONE NUMBER: 301/496-6331
PIC NUMBER: 5687
PERFORMER ORGANIZATION: Institute of Medicine,
National Academy of Sciences, Washington, DC
P.I.: Michael A. Soto, Ph.D.
TITLE: Survey of the Knowledge, Attitudes,
and Practices of Physicians Related to Blood Use, Transfusion, and
Donation
ABSTRACT NUMBER: 049
ABSTRACT: NHLBI conducted a nationwide survey
that will provide quantitative measures of the reported knowledge, attitudes,
and practices related to autologous and homologous blood transfusion and
donation that are held by two groups of practicing physicians--physicians in
specialty groups who are heavy users of blood and blood products and physicians
in specialty groups who are involved in primary patient care. These two groups
of physicians represent nine physician specialties--six specialties that are
heavy users of blood products (anesthesiology, general surgery, cardiovascular
surgery, orthopedic surgery, obstetrics and gynecology, and neonatology) and
three specialties of physicians involved in primary patient care (family
practice, internal medicine, and general practice). Specifically, the survey
measures how numerous advances in the use of blood and blood components and
alternatives to homologous blood transfusion have affected the medical
community. Survey results are being used to maximize the professional education
component of the National Blood Resource Education Program and thereby to
further ensure that blood and blood components are transfused only when
therapeutically appropriate to ensure an adequate supply of safe blood and
blood components to meet the Nation's needs.
FEDERAL CONTACT OFFICE: Office of Program
Planning and Evaluation, NHLBI
PERSON: Barbara Packard
PHONE NUMBER: 301/496-6331
PIC NUMBER: 4008
PERFORMER ORGANIZATION: Maya Tech Corporation,
Silver Spring, MD
Substance Abuse and Mental Health Services Administration
Listing of Abstract Titles
Evaluation Design for the Comprehensive Community Services Program
for Children With Serious Emotional Disturbance
Evaluation of Demonstration Treatment Programs in Job Corps
Evaluation of OSAP Demonstration Projects for Community
Partnerships
Evaluation of OSAP Demonstration Projects on Pregnant and Postpartum
Women and Their Infants (PPWI)
Making a Difference: Interim Status Report of the McKinney Research
Demonstration Programs for Homeless Mentally Ill Adults
Second Report to Congress on Alcohol and Drug Abuse Prevention,
1993
TITLE: Evaluation Design for the
Comprehensive Community Services Program for Children With Serious Emotional
Disturbance
ABSTRACT NUMBER: 050
ABSTRACT: This project developed an overall
design and instrumentation package for the Community Mental Health Services
Program for Children with Serious Emotional Disturbance. The design was
formulated to ensure that information needed to support Federal, State, and
local policymakers is readily available and that data collected are useful in
improving systems of care for children. The product of this contract is an
evaluation design, which will be implemented under another contract.
FEDERAL CONTACT OFFICE: Office of Demonstration
Programs, Center for Mental Health Services
PERSON: Roger Straw, Ph.D.
PHONE NUMBER: 301/443-3606
PIC NUMBER: 5029
PERFORMER ORGANIZATION: Macro International,
Calverton, MD
P.I.: Susan Zaro
TITLE: Evaluation of
Demonstration Treatment Programs in Job Corps
ABSTRACT NUMBER: 051
ABSTRACT: This evaluation examines the
cost-effectiveness of the Drug Treatment Enrichment Program in curbing drug use
among students receiving training at Job Corps Centers. Job Corps Centers are
residential employment and training programs for high-risk youth. The
evaluation, which began in July 1992 and continues for 4 years, compares the
course of the Drug Treatment Enrichment Program, which provides enhanced
services to curtail drug use, with the standard drug prevention and treatment
program used at Job Corps Centers. Student drug use is assessed at intake,
during, and 12 months after training at four centers with the enrichment
program and at four control centers with the standard program. The most recent
update from this demonstration program, covering almost 3,000 students entering
the centers over a 6-month period in 1993, is contained in the Second Annual
Report (November 1993). The enrichment program was found to be more successful
and also more costly than the standard program. While 63 percent of students
entering the enrichment program used drugs in the month before the program,
their drug use declined to 31 percent during the program. In contrast, while 69
percent of students entering the standard program reported drug use, their use
declined to 45 percent. The total cost of the enrichment program at each center
was 2.5 times that at the control center. The evaluation is still in progress,
with more updates expected.
FEDERAL CONTACT OFFICE: Office of Scientific
Analysis and Evaluation, Center for Substance Abuse Treatment
PERSON: Charlene Lewis
PHONE NUMBER: 301/443-7730
PIC NUMBER: 4523
PERFORMER ORGANIZATION: Caliber Associates,
Fairfax, VA
P.I.: Patricia Devine
TITLE: Evaluation of
OSAP Demonstration Projects for Community Partnerships
ABSTRACT NUMBER: 052
ABSTRACT: The National Evaluation of the
Community Partnership Demonstration Program (CPDP) is mandated by Congress to
document and describe CPDP's implementation and identify successful strategies
and common inhibitors to forming effective partnerships and implementing
intervention strategies. This is a two-tiered evaluation that includes a broad
assessment of all 251 partnerships, using routine collection and analysis of
uniform information and an intensive assessment of 36 selected partnerships.
The process and outcome evaluation is in its third and final year of data
collection, documentation, and evaluation of partnership form and function.
Interim reports were prepared in 1992 and 1993.
FEDERAL CONTACT OFFICE: Office of Scientific
Analysis and Review, Center for Substance Abuse Prevention
PERSON: Shakeh Kaftarian
PHONE NUMBER: 301/443-4783
PIC NUMBER: 4515
PERFORMER ORGANIZATION: ISA Associates,
Alexandria, VA
P.I.: Janice Roehl
TITLE: Evaluation of
OSAP Demonstration Projects on Pregnant and Postpartum Women and Their Infants
(PPWI)
ABSTRACT NUMBER: 053
ABSTRACT: This evaluation assessed the
implementation and effectiveness of the Pregnant and Postpartum Women and Their
Infants (PPWI) Demonstration Program funded between 1989 and March 1991. The
evaluation examined the process of implementing 90 PPWI grants: the
coordination of program services within a large community environment and
successes in overcoming obstacles to implementation. The outcome evaluation
included 26 PPWI projects and addressed program effectiveness and the impact of
the program on mother and child outcomes. Key findings of the evaluation
included the following: The PPWI grantees were successful in improving the
coordination, availability, and accessibility of health and alcohol and other
drug-related services. At least one-third of the women served by these programs
reduced their substance use. Babies born to PPWI clients were generally
healthy, especially if their mothers took full advantage of prenatal services.
Grantees made working agreements with an average of 13 other organizations for
delivery of comprehensive services.
FEDERAL CONTACT OFFICE: Office of Scientific
Analysis and Review, Center for Substance Abuse Prevention
PERSON: Soledad Sambrano
PHONE NUMBER: 301/443-9136
PIC NUMBER: 4517
PERFORMER ORGANIZATION: Macro International,
Calverton, MD
P.I.: James Ross
TITLE: Making a
Difference: Interim Status Report of the McKinney Research Demonstration
Programs for Homeless Mentally Ill Adults
ABSTRACT NUMBER: 054
ABSTRACT: This evaluation is a multisite
research demonstration project offering case management and housing to the
homeless mentally ill. A total of 896 homeless adults with severe mental
illness were randomly assigned to an intervention that combined housing and
social services or to traditional services. The interventions varied across
sites but were oriented to training participants in daily living, linking them
to needed social and medical services, and assisting them in the receipt of
entitlements and housing. Interim findings indicate that each of the five sites
has been successful in reducing homelessness and improving the mental health of
study participants: homeless adults with severe mental illness are willing to
use accessible services targeted to their needs. The factors contributing to
the success of the project include mental health treatment, receipt of
entitlement income, and reliance on an interdisciplinary team of staff,
including some formerly homeless people with mental illness. Participants'
substance abuse was more significant than their mental illness in preventing
them from finding or keeping housing. These interim findings are from followup
at 6 to 12 months. Final results, from followup at 18 to 24 months, are
expected to offer strategies for the design and management of programs for the
homeless mentally ill.
FEDERAL CONTACT OFFICE: Center for Mental Health
Services, SAMHSA
PERSON: Roger Straw, Ph.D.
PHONE NUMBER: 301/443-3606
PIC NUMBER: Unassigned
PERFORMER ORGANIZATION: Homeless Research
Project
P.I.: Anthony Lehman, M.D., The Baltimore
Project, Baltimore, MD
Stephen Goldfinger, M.D., The Boston Project, Boston,
MA
David Stern, Ph.D., The New York City Street Outreach
Project, New York, NY
Elie Valencia, J.D., The New York City Critical Time
Project, New York, NY
Richard Hough, Ph.D., The San Diego Project, San Diego,
CA
TITLE: Second Report to
Congress on Alcohol and Drug Abuse Prevention, 1993
ABSTRACT NUMBER: 055
ABSTRACT: The National Structured Evaluation is
the first systematic assessment of alcohol and other drug abuse prevention
approaches that have been implemented across the country. The overall objective
is to improve understanding of the elements of effective alcohol and other drug
abuse prevention. It will address three evaluation questions. Which current
prevention projects are effective and which factors contribute to their
success? Can successful prevention efforts be replicated to other target
populations? Which efforts are most effective with the general population, and
which ones are most effective with special populations? The first report to
Congress identifies drug abuse education and prevention efforts (including
practices of Federal, State, and local governments) that focus on reducing
alcohol and other drug abuse. The report lists programs that have evaluation
components and reviews the reported findings and conclusions. The results show
that many programs have not been evaluated; there are mixed results regarding
strategies, outcomes, and impact on different target populations; and
comprehensive community-based programs show the most promise. The report
recommends evaluation technical assistance for program managers; increased
program development research; support for comprehensive, community-based
programs; and development of an evaluation information center.
FEDERAL CONTACT OFFICE: Office of
Intergovernmental and External Affairs, Center for Substance Abuse
Prevention
PERSON: Mel Segal
PHONE NUMBER: 301/443-5266
PIC NUMBER: 4313
PERFORMER ORGANIZATION: Conwal, Inc., Falls
Church, VA
P.I.: Gay Hill, Ph.D.
Office of the Assistant Secretary fOR Health
Listing of Abstract Titles
Advanced Practice Nursing Education: Strategies for the Allocation of
the Proposed Graduate Nursing Education Account
Assessment of AIDS Non-Acute Care AIDS Treatment Facilities
Developing Effective Health Communication Strategies for High-Risk
Youth Outside of School
Evaluating Educational Outcomes of School Health Programs
Evaluation of NDMS 1992 Open Arms Exercise and Response to Florida
Hurricane Andrew
Evaluation of the 1990 U.S.-Mexico Border Sister Cities Health
Initiative: Final Report
An Evaluation of WomenÕs Reproductive Health Services Provided
in Community/Migrant Health Centers in Region VIII
For a Healthy Nation: Returns on Investment in Public Health
Improving the Supply, Training, and Distribution of Primary Care
Providers Under Federal Health Care Reform
Integration of Support Services Into Comprehensive Primary Care
Nutritional Status Indicators of Low-Income Populations
Patterns of Care for HIV/AIDS Patients
Region IX Hepatitis B Project Final Report
Report of the American Institute of Nutrition (AIN) Steering Committee
on Healthy Weight
Study Design for an Evaluation Study of the Vaccine Adverse Event
Reporting System (VAERS)
A Study of the Economic Underpinnings of Vaccine Supply
Supporting Statement for a Study To Evaluate the Effects of the Use of
"Put Prevention Into Practice" Materials in Primary Health Care
TITLE: Advanced Practice Nursing Education:
Strategies for the Allocation of the Proposed Graduate Nursing Education
Account
ABSTRACT NUMBER: 056
ABSTRACT: This project examines issues related
to the Administration's proposals to establish an all-payer pool to support
graduate nurse training as part of health care reform. It provides background
on the advanced practice nursing workforce and outlines possible approaches to
allocation of the proposed graduate nurse education (GNE) fund. Trends in
nursing supply and demand are addressed, including the number of nurses in
practice by type of training, geographic location, and practice setting as well
as statistics on the educational programs preparing them for practice. The
discussion begins with the registered nurse workforce, as these practitioners
form the pool eligible for advanced practice study, and moves to a
consideration of each of the four areas of advanced practice nursing
specialization (nurse practitioners, nurse-midwives, nurse anesthetists, and
clinical nurse specialists). Next, trends in the costs of nursing education and
sources of funding available to nursing programs and their students are
examined. Finally, the author puts forth strategies pertaining to the
allocation of GNE funds and gives details on cost simulations under various
options.
FEDERAL CONTACT OFFICE: Office of the Assistant
Secretary of Health, DHHS
PERSON: Marcy Gross
PHONE NUMBER: 202/690-5824
PIC NUMBER: 5668
PERFORMER ORGANIZATION: University of
Pennsylvania School of Nursing, Philadelphia, PA
P.I.: Linda H. Aiken, Ph.D., R.N.,
F.A.N.
TITLE: Assessment of
AIDS Non-Acute Care AIDS Treatment Facilities
ABSTRACT NUMBER: 057
ABSTRACT: The purpose of the project was to
evaluate how the designs of three types of AIDS treatment facilities affected
the services provided in the facilities. The question addressed was whether
certain facility design features either contribute to or detract from the
conduct of the treatment program(s) for which the facility is used. During the
4 fiscal years beginning with 1988, the Public Health Service made grants to
assist in the construction or renovation of non-acute, intermediate, and
long-term care facilities for patients with AIDS or other HIV-related
conditions. Projects eligible for assistance were those for (1) renovation of
existing traditional health care facilities such as hospitals and nursing
homes, and other than traditional health care facilities, such as residential
housing, and (2) construction of new health care facilities to provide
comprehensive intermediate and/or long-term care for some or all of the various
stages of illness an HIV-infected person may experience. Using a case study
approach, a team (consisting of an AIDS treatment professional with experience
in planning and implementing non-acute AIDS treatment programs and an architect
with experience in the design of health care facilities) evaluated each of six
facilities built in Region IX with grant assistance. The team gathered data
from grant application files, direct observation of the facilities, and
interviews with project sponsors. The final report describes significant
aspects of the design, construction, and program use of each facility.
Strengths and weaknesses of each facility are highlighted, with recommendations
for facility designers. Intended users of project findings are designers of
AIDS treatment facilities and treatment staff with responsibility for facility
planning.
FEDERAL CONTACT OFFICE: Disease Prevention and
Health Promotion, and Health Planning and Evaluation
PERSON: Paul Johnson, Ph.D.
PHONE NUMBER: 202/401-0734
PIC NUMBER: 5682
NTIS ACCESSION NUMBER: PB 95-194726
PERFORMER ORGANIZATION: ESS Architects, San
Francisco, CA
P.I.: Abelardo Ruiz
TITLE: Developing
Effective Health Communication Strategies for High-Risk Youth Outside of
School
ABSTRACT NUMBER: 058
ABSTRACT: This focus group study generated
information about the knowledge, attitudes, behaviors, beliefs, and
environments of at-risk youth. Youth are considered to be at risk if they are
ages 10 through 18 and regularly engage in tobacco use, substance use,
unprotected sex, and/or violence. Target population data were collected through
a literature review and focus groups. High-risk youth were found to be fairly
knowledgeable about healthy practices, but they do not incorporate this
awareness into practice. They were found to be willing to listen to trusted,
credible adults in alternative settings. Project findings suggest strategies to
(1) help service providers, intermediaries, families, and other adult role
models to become effective health communicators; (2) focus on linked behaviors
rather than categorical issues; and (3) integrate communications with programs
and services. This project is the first interdepartmental communications
research effort of the Public Health Service and the Departments of Justice,
Education, and Transportation.
FEDERAL CONTACT OFFICE: Office of Disease
Prevention and Health Promotion
PERSON: Mary Jo Deering, Ph.D.
PHONE NUMBER: 202/205-5968
PIC NUMBER: 4490
PERFORMER ORGANIZATION: S.W. Morris Company and
Global Exchange
P.I.: Ruth Karimi
TITLE: Evaluating
Educational Outcomes of School Health Programs
ABSTRACT NUMBER: 059
ABSTRACT: This evaluation design report presents
a general framework for assessing the effects of school health intervention on
students' school performance. As recognized by the Nation's health promotion
and disease prevention and education agendas--Healthy People 2000 and Goals
2000--health and education are inextricably linked: good health is necessary
for effective learning, and education is necessary for maintaining good health.
However, robust empirical evidence of this link from well-designed evaluations
does not exist. This study was undertaken to guide efforts to gather such
empirical evidence. This report begins with an overview of the eight general
categories of school health intervention: (1) health education, (2) health
services, (3) healthy school environments, (4) school nutrition services, (5)
physical education and fitness, (6) integrated school and community health
promotion, (7) school counseling, and (8) health promotion for faculty and
staff. It reviews the types of school performance measures and primary data
sources for obtaining those measures. Measures include educational achievement
(e.g., grade promotion patterns), student behaviors (e.g., attendance), and
student attitudes toward school and themselves. The primary data sources are
school records and student surveys. The report reviews the procedures needed to
collect data from each source and the issues regarding the use of intermediate
versus long-term educational outcomes. Two major design evaluation options are
presented. The first option is to use data collected by national surveys by the
National Center for Education Statistics. The second is to conduct multischool
demonstrations, either as add-ons to existing evaluation of the health outcomes
of school health programs or as new efforts to test alternative health
interventions. With these options, schools gain the tools to justify not only
the health importance but also the academic importance of their health
programs.
FEDERAL CONTACT OFFICE: Office of Disease
Prevention and Health Promotion
PERSON: James Harrell
PHONE NUMBER: 202/205-8611
PIC NUMBER: Unassigned
PERFORMER ORGANIZATION: Mathematica Policy
Research, Princeton, NJ
P.I.: Craig Thornton, Ph.D.
TITLE: Evaluation of
NDMS 1992 Open Arms Exercise and Response to Florida Hurricane
Andrew
ABSTRACT NUMBER: 060
ABSTRACT: The National Disaster Medical System
(NDMS) is a cooperative effort of public and private organizations and
individuals to provide emergency medical treatment, casualty evacuation, and
definitive medical care to victims of natural and manmade catastrophic
disasters. This system is a cooperative effort among four Federal Departments
and Agencies: the Department of Health and Human Services, the Department of
Defense, the Department of Veterans Affairs, and the Federal Emergency
Management Agency. The inadequate Federal response to Hurricane Andrew
stimulated a number of evaluations of Federal catastrophic disaster programs
and policies. These programs are usually activated by a request from the State
when State resources are overwhelmed. The Office of Emergency Preparedness
initiated an evaluation of NDMS emergency response, beginning with a conference
to assess its performance in the Florida hurricane response. The results led to
a full evaluation of the program. The results of the evaluation confirmed that
NDMS is a valuable program, but it needs to be strengthened. Seven issue areas
were identified, and other participants in the NDMS program were appointed to
develop options and recommendations for these issue areas.
FEDERAL CONTACT OFFICE: Disease Prevention and
Health Promotion, and Health Planning and Evaluation
PERSON: Paul Johnson, Ph.D.
PHONE NUMBER: 202/690-7945
PIC NUMBER: 5691
PERFORMER ORGANIZATION: Maximus, McLean,
VA
TITLE: Evaluation of the
1990 U.S.-Mexico Border Sister Cities Health Initiative: Final
Report
ABSTRACT NUMBER: 061
ABSTRACT: This report contains an evaluation of
the activities initiated by the Office of International Health during 1990-91
to enhance the presence of the Public Health Service (PHS) in the U.S.-Mexico
border region, with the objective of improving public health status. The
activities included the U.S.-Mexico Border Health Group, Project Consenso, and
the Sister Cities Health Initiative. The evaluation provided insights into
these activities to guide future PHS efforts in bilateral health activities in
the U.S.-Mexico border region. There are mutual concerns over the problems of
air pollution, toxic waste dumping, sewage and water contamination, traffic
congestion, and lack of services. The evaluators felt that Project Consenso was
a success in that it set the stage for the continuation of a management process
for the conduct of bilateral activities in health. It also pointed up the
unique nature of the border communities and the need for U.S. and Mexican
national presence in discussions regarding what are normally local public
health issues. The strongest aspect of the development of the Sister Cities
Health Initiative projects was the spirit of binational cooperation exhibited
by all the participants. Ongoing dialog among the participants focusing on the
role of local health authorities and technical assistance were key to project
development and strongly suggest the model for future progress in the border
region. The intent of the Sister Cities Health projects is to reinforce and
strengthen local infrastructure, and it appears that they are doing just that.
There was strong sentiment for more clearly defining the PAHO Field Office role
in border activities. It was felt that the office could adopt a more
consultative role with public and private health institutions on the border.
The report contains recommendations made by participants interviewed to
facilitate the continuing process of managing binational health issues in the
border region.
FEDERAL CONTACT OFFICE: Disease Prevention and
Health Promotion, and Health Planning and Evaluation
PERSON: Paul Johnson, Ph.D.
PHONE NUMBER: 202/690-7945
PIC NUMBER: 5628
PERFORMER ORGANIZATION: M.S. Mexico Border
Health Association, El Paso, TX
P.I.: Ignacio G. Gosset, Ph.D.
TITLE: An Evaluation of
Women's Reproductive Health Services Provided in Community/Migrant Health
Centers in Region VIII
ABSTRACT NUMBER: 062
ABSTRACT: In 1993, a multidisciplinary
interagency task force was formed to assess reproductive health services in
various public health agency programs. The task force identified a gap in
reproductive health care information in the community/migrant health care
setting and embarked on an evaluation project to examine the regional public
health information infrastructure. The evaluation study focused on a
representative sample of women 20 to 44 years of age who received reproductive
health care services from one of 36 study sites. A 220-item data collection
instrument was designed to collect and analyze the frequency and extent of
services provided. Findings were also compared across urban, rural, and
frontier study populations. The demographic and utilization patterns revealed
that the typical client was a married, Hispanic, employed female with a high
school education, between 25 and 29 years of age. Preventive health screenings
were the most highly documented health services delivered (blood pressure,
weight, and pap smears). Prenatal records were consistently the most complete.
Documentation for reproductive and other types of health promotion education
and counseling appeared low when compared with other services. Services related
to reporting of abuse and violence were the most poorly documented, followed by
reporting of mental health problems. The evaluation study will provide regional
programs with an information base to assess services for continuous improvement
of quality of care.
FEDERAL CONTACT OFFICE: Disease Prevention and
Health Promotion, and Health Planning and Evaluation
PERSON: Paul Johnson, Ph.D.
PHONE NUMBER: 202/690-7945
PIC NUMBER: 5670
NTIS ACCESSION NUMBER: PB 95-193686
PERFORMER ORGANIZATION: University of Colorado
Health Sciences Center, Denver, CO
P.I.: Gene W. Marsh, Ph.D.
TITLE: For a Healthy
Nation: Returns on Investment in Public Health
ABSTRACT NUMBER: 063
ABSTRACT: This study describes public health programs
and the role they play at the national, State, and local levels in avoiding
preventable injury and illness and decreasing demand for personal care
services. It also suggests the need to increase the research base on the
effectiveness of public health strategies. The population-based approaches
described have provided the foundation for significant improvements in health
and life expectancy, including declines in heart disease and stroke, infectious
disease, and motor vehicle and workplace injuries. Other successes include the
virtual elimination of polio since the mid-sixties, declines of nearly 50
percent in dental decay in children since 1974, and a 70 percent reduction in
childhood blood lead levels since 1976. At the same time, persistent public
health problems remain (e.g., outbreaks of new infectious diseases such as AIDS
and familiar diseases such as tuberculosis). Tuberculosis provides an
instructive example of a strong public health program that was effective in
controlling a disease that resurged when the program was dismantled, resulting
in 39,000 preventable cases and $421 million in avoidable direct medical costs
between 1985 and 1992. This evaluation finds that appropriate investment in
public health may lead to future savings on the medical care side. For example,
conservative estimates of the impact of population-based strategies aimed at
heart disease, stroke, occupational injuries, motor vehicle-related injuries,
low birthweight, and gunshot wounds suggest that $69 billion in medical care
spending for these conditions could be averted by 2000. This reduction will be
achieved through reductions in cases of heart disease and stroke, estimated to
reach 8.4 million and 3.3 million cases avoided, respectively, by 2015 as a
result of public health prevention strategies.
FEDERAL CONTACT OFFICE: Disease Prevention and
Health Promotion, and Health Planning and Evaluation
PERSON: Paul Johnson, Ph.D.
PHONE NUMBER: 202/690-7945
PIC NUMBER: 5680
PERFORMER ORGANIZATION: Battelle, Arlington,
VA
P.I.: Bryan A Luce, Ph.D.
TITLE: Improving the
Supply, Training, and Distribution of Primary Care Providers Under Federal
Health Care Reform
ABSTRACT NUMBER: 064
ABSTRACT: This project provided an analysis of
issues related to proposals for improving the supply, training, and
distribution of primary care providers as part of health care reform. Many of
the health care reform proposals considered by Congress included provisions
that would have changed the mechanism for making decisions with respect to the
number and types of new physicians. Information provided in this report
includes a chart book on the supply, training, and distribution of physicians;
technical papers providing background on the need for increased numbers of
generalist physicians and the rationale for proposals to control the supply of
new physicians; proposals for an all-payer pool for graduate medical education;
estimates of the number of physicians in research training tracks at NIH and
elsewhere; and preliminary estimates of the number of advanced practice nurses
and physician assistants that would be needed to substitute for physicians if
the number of physician residents were reduced.
FEDERAL CONTACT OFFICE: Disease Prevention and
Health Promotion, and Health Planning and Evaluation
PERSON: Paul Johnson, Ph.D.
PHONE NUMBER: 202/690-7945
PIC NUMBER: 5666
PERFORMER ORGANIZATION: Center for Health Policy
Research, George Washington University, Washington, DC
P.I.: Michele Solloway, Ph.D.
TITLE: Integration of
Support Services Into Comprehensive Primary Care
ABSTRACT NUMBER: 065
ABSTRACT: Federally funded community and migrant
health centers (C/MHCs) and other community resources, such as the Supplemental
Food Program for Women, Infants, and Children (WIC) and mental health centers,
are the principal resources for the prevention, detection, and treatment of a
variety of health problems. The need to evaluate the integration of nutrition,
mental health, social work, and dental services provided through the C/MHCs or
their linkages with other community resources is evidenced by the compromised
health status of underserved clients in this country. This project evaluated
the integration of nutrition, mental health, social work, and dental services
provided at C/MHCs with emphasis on special categorical populations, such as
the HIV-infected, the homeless, substance abusers, women, and children. The
final report includes analysis of the survey responses, reports of the site
visits, and recommendations for techniques and strategies that can improve
integration of services.
FEDERAL CONTACT OFFICE: Disease Prevention and
Health Promotion, and Health Planning and Evaluation
PERSON: Paul Johnson, Ph.D.
PHONE NUMBER: 202/690-7945
PIC NUMBER: 5657
NTIS ACCESSION NUMBER: PB 95-193728
PERFORMER ORGANIZATION: Wilson Yoak Associates,
Jefferson City, MI
P.I.: Lorna M. Wilson, R.N., M.P.H.
TITLE: Nutritional
Status Indicators of Low-Income Populations
ABSTRACT NUMBER: 066
ABSTRACT: In 1988, the Public Health Service
joined with the American Institute of Nutrition (AIN) in a cooperative
agreement to examine state-of-the-art techniques for measuring nutritional
status and to make recommendations for a core set of nutritional status
indicators for low-income populations. A workshop, several symposia, and an AIN
multidisciplinary task force on core indicators of nutritional status were
planned and carried out. The collected reports resulting from these activities
have been compiled in a final report. The task force drew on the symposia and
workshop papers in its assessment, which provides an introduction to the
concept of nutritional state and the components that must be considered in
identifying core indicators for its assessment in difficult-to-sample
populations. These components include food security, nutritional concerns,
survey coverage, and sampling concerns. Core indicators of nutrition state are
suggested in the context of the purposes for which the data are used.
FEDERAL CONTACT OFFICE: Disease Prevention and
Health Promotion, and Health Planning and Evaluation
PERSON: Paul Johnson, Ph.D.
PHONE NUMBER: 202/690-7945
PIC NUMBER: 5658
NTIS ACCESSION NUMBER: PB 95-193736
PERFORMER ORGANIZATION: American Institute of
Nutrition, Bethesda, MD
P.I.: Richard G. Allison, Ph.D.
TITLE: Patterns of Care
for HIV/AIDS Patients
ABSTRACT NUMBER: 067
ABSTRACT: This study examined patterns of care
for HIV/AIDS patients who received services in federally funded community
health centers in New York and New Jersey. Site visits were made to a sample of
six urban centers that represented different types by organizational setting
(hospital-based, hospital-affiliated, and freestanding) and by health services
delivery orientation (designated AIDS clinic or integrated care plan). The
focus of the study was to describe the health services delivery models used by
the centers or their approach to administration, organization, and operation of
HIV-related health service programs and activities. The study found that
despite differences in the organization of the centers, the administration and
provision of services is basically the same. The report also presents findings
on the types of services delivered, the role of case management, and increased
demand for services by high-risk groups.
FEDERAL CONTACT OFFICE: Disease Prevention and
Health Promotion, and Health Planning and Evaluation
PERSON: Paul Johnson, Ph.D.
PHONE NUMBER: 202/690-7945
PIC NUMBER: 4498
PERFORMER ORGANIZATION: Market Care, New York,
NY
P.I.: George Z. Cestero
TITLE: Region IX Hepatitis B Project Final
Report
ABSTRACT NUMBER: 068
ABSTRACT: The purpose of the project was to
evaluate the effectiveness of hepatitis B health education/outreach program
activities at six federally funded primary care centers in Region IX that
target Asian and Pacific Islander patients. The carrier rate of this disease
ranges from 10 to 15 percent in the Asian Pacific population in contrast to 0.3
percent in the U.S. population. The study objectives were to examine the role
Southeast Asian refugee and Asian immigrant leaders play in the design and
delivery of health education programs; develop criteria for measuring effective
health education programs; identify effective hepatitis B health education
programs; and identify the elements of effective programs. Three major barriers
to the development of effective hepatitis B programs for Asian and Pacific
Islander populations were identified: (1) lack of understanding of the
importance of hepatitis B screening and vaccination by the patient population;
(2) lack of reimbursement by third parties for hepatitis B screening and
vaccines for adolescents and adults (currently, reimbursement is provided only
for prenatal patients); and (3) limited availability of bilingual/bicultural
interpreters trained in health education materials. The final report recommends
that the following elements should be included in effective hepatitis B
outreach and education programs: (1) staff who are sensitive to cultural
beliefs and attitudes affecting hepatitis B; (2) reimbursement for hepatitis B
screening and vaccines for all age groups; (3) translated health education
materials; (4) integrated hepatitis B activities with standard patient care
protocols; (5) use of ethnic media (TV, radio, newspapers, magazines); and (6)
linkages with school-based health programs and other community-based outreach
programs serving the high-risk Asian/Pacific Islander population.
FEDERAL CONTACT OFFICE: Disease Prevention and
Health Promotion, and Health Planning and Evaluation
PERSON: Paul Johnson, Ph.D.
PHONE NUMBER: 202/690-7945
PIC NUMBER: 5681
NTIS ACCESSION NUMBER: PB 95-193389
PERFORMER ORGANIZATION: Association for Asian
Pacific Community Health Organization, Oakland, CA
TITLE: Report of the
American Institute of Nutrition (AIN) Steering Committee on Healthy
Weight
ABSTRACT NUMBER: 069
ABSTRACT: As part of a cooperative effort
between the Department of Health and Human Services' Public Health Service and
the American Institute of Nutrition (AIN), AIN convened a 2-day workshop to
review new data and perspectives pertinent to defining "healthy weight." AIN
provided transcripts of the workshop and copies of submitted materials to
PHS/OASH/ODPHP. A report from the AIN Steering Committee on Healthy Weight was
published in the Journal of Nutrition (124:2240-2243, 1994). The
report summarizes the Steering Committee's conclusions from the workshop,
including areas of agreement, and identifies issues for which further data and
discussions are needed. The report has been provided to the 1994-95 Dietary
Guidelines Advisory Committee for use in its deliberations on the definition of
healthy weight.
FEDERAL CONTACT OFFICE: Disease Prevention and
Health Promotion, and Health Planning and Evaluation
PERSON: Paul Johnson, Ph.D.
PHONE NUMBER: 202/690-7945
PIC NUMBER: 5014
PERFORMER ORGANIZATION: American Institute of
Nutrition, Bethesda, MD
P.I.: Richard G. Allison, Ph.D.
TITLE: Study Design for
an Evaluation Study of the Vaccine Adverse Event Reporting System
(VAERS)
ABSTRACT NUMBER: 070
ABSTRACT: This project provided an evaluation
design to assess the functional capabilities (including reliability and data
quality) of the Vaccine Adverse Event Reporting System (VAERS). It examined
methods for improving reporting, followup, and analysis of VAERS data, and
assessed the level of awareness about VAERS among health care providers and
consumers. There are four major evaluation points: (1) the degree to which this
system meets the program's needs and legislative requirements; (2) the
reliability and accuracy of information submitted to it, including how well
instructions are followed when completing forms; (3) management of secondary
and/or followup information; and (4) the perception of VAERS among health care
providers, manufacturers, and consumers.
FEDERAL CONTACT OFFICE: Disease Prevention and
Health Promotion, and Health Planning and Evaluation
PERSON: Paul Johnson, Ph.D.
PHONE NUMBER: 202/690-7945
PIC NUMBER: 5013
PERFORMER ORGANIZATION: Research Triangle
Institute, Washington, DC
P.I.: James S. Lubalin, Ph.D.
TITLE: A Study of the
Economic Underpinnings of Vaccine Supply
ABSTRACT NUMBER: 071
ABSTRACT: This project studied the economic and
commercial underpinnings of ensuring an adequate supply and distribution of
vaccines. The project conducted a meta-analysis of related vaccine supply
studies to identify alternative models for the purchase and distribution of
vaccines; the effect of scientific advances on research, development, and
purchase of vaccines; the application of economic theory to the vaccine market;
comparisons of vaccine distribution systems administered by vaccine
manufacturers and State agencies; and the implications of purchasing vaccines
from foreign firms. The final report presented findings on price increases in
vaccines since 1977; factors affecting production of supply; the economics of
public versus private sector supply of vaccines; and the limited importance of
foreign suppliers in meeting U.S. needs. The study found, for example, that
States that supply vaccines at low prices to physician offices and encourage
parents to have their children vaccinated have somewhat higher rates of
immunization. These and many other findings have enhanced CDC's ability to
negotiate lower prices from manufacturers and have broad utility for policy and
legislation.
FEDERAL CONTACT OFFICE: PHS-CDC
Immunization/Vaccine Stockpile, National Vaccine Program Office
PERSON: Chester Robinson, D.P.A.
PHONE NUMBER: 301/594-6350
PIC NUMBER: 5015
PERFORMER ORGANIZATION: Mathematica Policy
Research, Princeton, NJ
P.I.: Craig Thornton, Ph.D.
TITLE: Supporting
Statement for a Study To Evaluate the Effects of the Use of "Put Prevention
Into Practice" Materials in Primary Health Care
ABSTRACT NUMBER: 072
ABSTRACT: This project developed an evaluation
instrument to measure the impact of Put Prevention Into Practice (PPIP)
materials on the delivery of preventive care services by primary care
providers. Data generated will help PHS develop and refine the PPIP materials
and provide direction to other Federal Agencies interested in using PPIP
materials in their programs. This information will help primary care providers,
national primary care provider organizations, and the academic community
determine the appropriate use of these materials in clinical practice and
education. These data will also provide policymakers involved with the reform
of the health care delivery system with information on the utility of PPIP
materials in increasing the delivery of clinical preventive services by primary
care providers.
FEDERAL CONTACT OFFICE: Disease Prevention and
Health Promotion, and Health Planning and Evaluation
PERSON: Paul Johnson, Ph.D.
PHONE NUMBER: 202/690-7945
PIC NUMBER: 5662
PERFORMER ORGANIZATION: Battelle, Arlington,
VA
P.I.: James O. Hersey, Ph.D.