Findings from an evaluation of a model system for delivering mental health services to youth were reassessed to determine the robustness of key findings to the use of methodologies unavailable to the original analysts. These analyses address a key concern about earlier findings--that the quasi-experimental design involved the comparison of two…

Strategies to avoid the penalties of extra variation described by J. Cornfield and reduced degrees of freedom in community-level trials were compared in Monte Carlo simulations. The three conditions necessary to ensure nominal Type I and Type II error rates are detailed. (SLD)

Various disparate activities have been defined as outreach, which is an element of social service/disease prevention programs. The history of outreach as a project element within federal social programs, central sources of variations in this element, measures of effectiveness and cost effectiveness, and recurring implementation issues are…

A Monte Carlo study compared performance of linear and logistic mixed-model analyses of simulated community trials having specific event rates, intraclass correlations, and degrees of freedom. Results indicate that in studies with adequate denominator degrees of freedom, the researcher may use either method of analysis, with certain cautions. (SLD)

A methodology for developing clinical/research assessment tools, training interviewers, and continuously assessing interrater reliability is discussed. Data from a multisite national evaluation of long-term health care programs (i.e., the Social/Health Maintenance Organization (HMO) for elderly clients) are used. Focus is on providing research…

A method is described for increasing residual degrees of freedom in a community experiment without substantially increasing cost or difficulty by dividing experimental subunits into batches. Theoretical advantages of batch sampling are described and illustrated with data from the Pawtucket Heart Health Program. (SLD)

Two evaluation studies using qualitative methods are described to illustrate the appropriateness of such methods for certain research questions. Ways to enhance reliability and validity are also discussed in the descriptions of the evaluations of 16 emergency medical services and 13 local health departments. (SLD)

In the evaluation of a treatment program for veterans of the Lebanon War suffering from post-traumatic stress disorder, repeated administration of self-report instruments revealed no improvement in symptoms and social functioning. These findings conflicted with the positive evaluations of the program by participants (N=41) and therapists. (SLD)

The efficacy of an Assertive Community Treatment approach in preventing jail recidivism for the mentally ill was compared with that of forensic specialist case management or referral to mental health centers. More experimental subjects (total final sample of 94) returned to jail within a year. (SLD)

Articles in this special issue consider different aspects of community-level evaluation research and demonstrate the emerging sophistication and promise of this field. Process evaluation, qualitative research, and meta-analysis are promising new directions for ensuring more appropriate levels of analysis and more appropriate outcomes. (SLD)

A methodology is presented for collection of cost data in evaluation of community-level health interventions that coincides with the intervention implementation. The seven discrete steps of the analysis are described, and the Minimal Contact Education for Cholesterol Change study is used as an example of how the strategy is used. (SLD)

This paper describes a six-month service-coordination pilot project (SCPP) designed to improve coordination activities among mental health service providers in a Canadian city. The aim of the project was to improve information sharing and joint treatment planning. Data show no effect of the SCPP, but service providers perceived improvements. (TJH)

Social-historical lineages of adolescent alcohol and other drug use prevention programs are examined, tracing risk factor research from assumptions of deviance regarding the mentally ill and considering patterns that have inhibited advances in prevention. To achieve program success, protective factor and harm reduction approaches must be explored.…

Statistical approaches to assess how prevention and intervention programs achieve their effects are described and illustrated through the evaluation of a health promotion program to reduce dietary cholesterol and a school-based drug prevention program. Analyses require the measurement of intervening or mediating variables to represent the…

The relationship between a 4-group (control and low- through high-intensity intervention) health promotion intervention program and subsequent medical costs was analyzed for 1,188 employees in a California utility company. Results suggest strong associations between health promotion interventions and subsequent reduction in medical care costs,…