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Intrah conducts training in family planning for health workers in Africa and Asia. This paper assesses the training on the basis of reactions of participants and a model that views participant reactions as a function of characteristics of the setting in which the training takes place, training event, and the participants. Data are participant reactions from 1659 trainees in 92 events from 1984 to 1987. Factor analysis is used to reduce fifteen participant reaction items to a smaller set of dimensions. Regression analysis is used to test the conceptual model. Analysis produced five participant reaction factors, usefulness of the training, practicality of the training, presentation, a trainer rating and extent of activity. Between twenty six and fifty six percent of the variance in these measures is accounted for by the variables selected on the basis of the conceptual model.

Time series analysis is a technique which has been utilized by econometricians and others for examining the relationship between events and time, particularly for forecasting purposes. More recent work has focused on time series analysis as a method to evaluate the effects of an exogenous event on a series. The major advantage of the interrupted time series design over a simple pre-post comparison is that the form of the change is taken into account. This paper will examine two alternative models for analyzing such data: regression and ARIMA. An example of the application of the two models will be demonstrated using data on highway deaths in North Carolina occurring before and after the national reduction in speed limits instituted in 1974. Conclusions are drawn about the comparative usefulness of these two techniques for program evaluation.

This study develops a model of the adaptive behavior of hospital administrators to the mandate to implement consumer participation. The model consists of three variable sets contextual variables describing the economic and social milieu of the hospitals; implementation variables which describe structural aspects of the advisory boards; and outcome variables related to the study program objective of facilitating both delivery and community utilization of ambulatory services.

Consumer participation in the planning and management of health care programs is prescribed as a method for increasing provider responsiveness to the goals and needs of users of services. However, issues related to the nature of mandates to implement consumer participation, provider-consumer interaction, and objectives for consumer participation help explain why, in fact, consumer participation has not had the impact on policy development proposed for it. While structural changes can be identified which might enhance the consumer role in decision making, it will also be necessary for the consumer sector to develop a strategy which will prompt major rather than incremental movement.

Six of eight local health departments in North Carolina's Southwest Perinatal Region III participated in a PBMS demonstration project also involving the state health department, the Centers for Disease Control, and the School of Public Health of the University of North Carolina at Chapel Hill. In all six counties the problem of reducing prematurity and low birthweight was selected to test this innovation. Using standardized instruments, staff awareness of and concern for low birthweight problems and programs were measured, as was level of success of implementation of PBMS. Factor analysis of three rounds of Awareness and Concern responses produced three uncorrelated factors: awareness of low birthweight problems, awareness of low birthweight programs, and concern for low birthweight. The results suggest that the PBMS increased awareness of the problem and the program, and that the project succeeded in half of the counties, helped some counties achieve some goals, and provided some benefits to some counties. The implications for Total Quality Management are discussed.

The design of clinical protocols is an important factor in assuring patient accrual and compliance. This paper describes the methods used to assess the attributes of treatment and cancer control research protocols. Measures are presented for assessing three attributes considered important: relative advantage, complexity, and compatibility.

A widely held, but unproven assumption holds that health insurance which financed more comprehensive services for ambulatory patients would significantly lower the rate of hospital admissions. This study reports on an attempt to test this assumption through a statistically controlled experiment. The Kansas Blue CrossBlue Shield Plan provided free outofhospital benefits to an experimental group of 5,000 contracts for eight months during 1968. This group's inpatient claims experience was tested for significant changes by comparisons with prior experience and with a control group of 10,000 contracts. While the experimental benefits did not significantly alter the experimental group's total inpatient utilization rates, further analysis suggests that the benefits might have affected the distribution of inpatient care.

RA394 1-58798-230-7 Evaluation and decision making for health services, 3d ed. (reprint, 1998) Veney, James E. and Arnold D. Kaluzny. BeardBooks, [c]2004 436 p. $34.95 (pa) Focusing on evaluation as [...]

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