No abstract

There is considerable interest within the public health community in the evaluation of programs intended to reduce health disparities. This commentary discusses an attempt to evaluate a prenatal clinic in a community-based organization serving disadvantaged African American women. The staff members of the clinic were convinced that the birth outcomes of their patients were better than might be expected from national data. The available data, however, were insufficient to permit a clear conclusion regarding the effectiveness of this clinical service. Nonetheless, data from focus groups conducted among staff members and current clients of the clinic suggested some reasons why birth outcomes might be better in this clinic. These reasons were supported both by the stress and coping literature and by empirical research into the determinants of birth outcomes. The article concludes with a discussion of some of the issues that need to be addressed by evaluators working in community-based organizations.