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EVALUATIONS
COMPLETED IN FY 2007
Universal
Newborn Hearing Screening and Intervention Program
In 2004, a contract was executed with Mathematica
Policy Research to conduct an evaluation of the Universal
Newborn Hearing Screening and Intervention (UNHSI)
program administered by the Health Resources and Services
Administration’s (HRSA) Maternal and Child Health
Bureau (MCHB). The work was carried out in 2005 through
an OMB approved survey mailed to 57 States and Territories
and selected site visits. There was a 100% response
to the survey. Although screening rates in the program,
which began in 2000 have climbed steadily from a beginning
rate of 35% to the current rate of 95%, the delivery
of appropriate and timely follow-up services has continued
to be a problem. Mathematica identified the following
barriers in the service delivery system: 1. lack
of service system capacity, 2. lack of provider knowledge,
3. family challenges in obtaining services, and 4.
information gaps remain, particularly in the public
domain. Recommendations included: 1.improving data
systems to support surveillance and follow-up activities,
2. building capacity beyond identified key providers,
3. improving data systems to support surveillance
and follow-up activities, 4. building capacity beyond
identified key providers, 5. developing family-to-family
support services, and 6. promoting understanding of
the importance of early detection in both the provider
community and among families. Many UNHSI programs
appear poised to take these action steps. Most programs
have implemented universal screening in their States,
and many are working actively to address key barriers
and reduce loss to follow-up. HRSA’s MCHB has an
important role to play in monitoring these activities
and helping to identify and disseminate effective
program strategies. The report was completed in 2006
and released to the public in December 2007.
Ryan White HIV/AIDS Program
“Review of the Management
of Unobligated Funds Provided by Title I of the Ryan
White Comprehensive AIDS Resources Emergency Act”
(A-02-03-02006) (Final Report - February 2007). The
findings of this Office of Inspector General audit
indicated that HRSA did not always comply with Departmental
policy that limit the carryover of unobligated grant
balances to the next budget year only. These funds
were originally awarded to provide services during
a specific budget year were instead carried over for
use in subsequent budget periods. Departmental policy
guidance issued after the audit period now permits
the carryover of unobligated grant funds into either
of the next two budget periods. HAB has taken appropriate
steps and follows current Departmental policy regarding
the approval of carryover requests from Part A (Title
I) grantees.
“Review of the Management
of Unobligated Funds Provided by Title II of the Ryan
White Comprehensive AIDS Resources Emergency Act”
(A-06-04-00060) (Final Report - May 2007). The
findings of this Office of Inspector General audit
indicated that HRSA did not always comply with Departmental
policy that limit the carryover of unobligated grant
balances to the next budget year only. These funds
were originally awarded to provide services during
a specific budget year were instead carried over for
use in subsequent budget periods. Departmental policy
guidance issued after the audit period now permits
the carryover of unobligated grant funds into either
of the next two budget periods. HAB has taken appropriate
steps and follows current Departmental policy regarding
the approval of carryover requests from Part B (Title
II) grantees. Additionally, the Part B program will
examine the reasons for some States’ large unobligated
balances, and monitor compliance to obligate 75 percent
of grant award with in 120 days.
Family Planning
Project: Assessment of Parent Involvement Strategies
in Programs Serving Adolescents
The study assessed the effectiveness of Parental
Involvement Strategies to influence adolescent behavior
in Title XX Prevention (of pregnancy) and Care (to
parenting adolescents) programs and Title X (family
planning) programs. There were two major assessment
approaches: (1) a literature assessment; and (2) Site
visits to 5 Title X family planning projects, 5 Title
XX Prevention projects for adolescent pregnancy, and
5 Title XX Care projects for pregnant and parenting
adolescents. The site visits collected qualitative
data on parental involvement strategies used, barriers
encountered and lessons learned. The literature assessment
examined a wider range of reproductive health programs
with parental involvement components, and focused
on those with the best available systematic evidence
on the impact of program components on adolescents'
reproductive health attitudes and behaviors. For the
literature assessment, 26 studies of parent involvement
programs were examined, including 14 randomized controlled
trials. Overall, there was mixed evidence for effectiveness
of parent involvement programs. A number of limitations
to the best available studies were noted, suggesting
the need for more evaluation effort in this area.
From the site visit studies, it became very clear
that inducing parents to participate in such programs
in significant numbers is quite difficult. Barriers
to parental participation are quite pronounced, with
logistics, psychosocial factors, relationship dynamics
and cultural issues among the obstacles.
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