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Surveys are a crucial tool for understanding public opinion and behavior, and their accuracy depends on maintaining statistical representativeness of their target populations by minimizing biases from all sources. Increasing data size shrinks confidence intervals but magnifies the impact of survey bias, an instance of the Big Data Paradox (Meng 2018). Here we demonstrate this paradox in estimates of first-dose COVID-19 vaccine uptake in US adults: Delphi-Facebook (about 250,000 responses per week) and Census Household Pulse (about 75,000 per week). By May 2021, Delphi-Facebook overestimated uptake by 17 percentage points and Census Household Pulse by 14, compared to a benchmark from the Centers for Disease Control and Prevention (CDC). Moreover, their large data sizes led to minuscule margins of error on the incorrect estimates. In contrast, an Axios-Ipsos online panel with about 1,000 responses following survey research best practices (AAPOR) provided reliable estimates and uncertainty. We decompose observed error using a recent analytic framework to explain the inaccuracy in the three surveys. We then analyze the implications for vaccine hesitancy and willingness. We show how a survey of 250,000 respondents can produce an estimate of the population mean that is no more accurate than an estimate from a simple random sample of size 10. Our central message is that data quality matters far more than data quantity, and compensating the former with the latter is a mathematically provable losing proposition., Comment: Revised and reformatted for journal

Explores the ideals associated with reform in systems of support for people with developmental disabilities. In particular the ways in which these ideals are fueling initiatives around the country, the challenges that constraint their full realization, and the steps that must be taken to keep the developmental disabilities system moving in a progressive direction are discussed. (Author/MKA)

The monograph advances a conceptual framework for the evaluation of mental health services provided to chronically mentally ill persons by psychosocial rehabilitation programs. Evaluation mechanisms consistent with the philosophy and programmatic aims of psychosocial rehabilitation programs are identified. An introductory section provides a brief history of the psychosocial rehabilitation movement, proposes a conceptual framework, and highlights existing evaluation publications which may be of use to program administrators. The next five sections describe components of a comprehensive evaluation strategy, focusing on the following dimensions of psychosocial rehabilitation programs: (1) input (agency mission, client characteristics and needs, staff competencies, financial condition); (2) process (program practices, program connectedness, match to need); (3) output (productivity evaluation, staff productivity); (4) outcome (client satisfaction, family satisfaction, client outcomes); (5) output/outcome (cost effectiveness, cost/benefit analysis). Within each section, relevant literature is reviewed, specific techniques described, methodological concerns aired, and resource constraints noted. The final section discusses the implications of evaluation, including the uses of information to improve services, the role of "inside" versus "outside" evaluation, and the potential future directions that evaluation is likely to take. A bibliography and appendix containing a client evaluation survey conclude the document. (JW)

The report examines implications of applying a functional rather than categorical definition of disabilities to Connecticut's services for the developmentally disabled. Specific objectives included preparation of an overview of services available, an analysis of policy options and system constraints, an analysis of the implications of reorganizing services, and a discussion of implementation phases. The first section of the report lists project goals and project methods and products. The second section describes a policy framework underlying the project's general approach to policy development. The following section describes the project context including trends at the federal level, the historical background of the service system in Connecticut, the extent of the current service system and the strengths and weaknesses of programs for persons with disabilities. The next section describes the experience of other states (New Jersey, Ohio, Maryland, Hawaii, California) that have reorganized their services along more functional lines. The final section presents the principles that should govern the service system, the outlines of recommended changes, the implications of such changes regarding demand and cost, and the ramifications for service eligibility procedures. This concluding section also discusses implementation phases. An appendix contains instruments used to screen adult applicants to the Division of Developmental Disabilities. (DB)

This study examined the impact of deinstitutionalization of the mentally retarded on their communities, the extent of availability of support services, and the extent to which the Connecticut Department of Mental Retardation assures adequate quality of support services and day programs for people with mental retardation living in community residential facilities. Project components include: (1) a research literature review; (2) a description of the current system of planning, residential development and quality assurance; (3) case studies of six communities where people with mental retardation have been relocated from institutions; (4) content analysis of relevant media coverage; (5) a study of 12 individual placements into community-based residences in these six communities; and (6) a phone survey of 5 service providers in non-urban areas aimed at discovering problems experienced in accessing services for their residents. Results call for "fine tuning" of planning, placement, transitions, community entry/development, accessibility, quality assurance, and global issues. The appendixes include: the study design and interview guides; a literature review; and a description of the formal system. Includes 47 references. (PB)