Private-public partnerships are increasingly seen as an important mechanism for improving community health. Despite their popularity, traditional evaluations of these efforts have produced negative or mixed results. This is often attributed to weak interventions or an insufficient period of time to observe an impact. This study examines two additional possibilities--the need for a well-articulated shared vision and the governance and management capabilities of the partnership itself. We conducted a midstream process evaluation of twenty-five community partnerships associated with the Community Care Network (CCN) Demonstration Program. We examined how the roles of a common shared vision, strong governance, and effective management influence a partnership's ability to achieve its objectives. The findings, based on both qualitative and quantitative analyses, underscore the importance of membership organizations' perceived benefits and costs of participation and management capabilities to the partnership's progress toward a vision. Based on the qualitative data, six key governance and management characteristics are identified that separate the top performing partnerships from the lowest performing ones. We explore the implications of this research for future evaluations of public-private community health partnerships.
Investment in voluntary partnerships raises important questions: Should we invest in collaboration in moving toward the goals of health system redesign? What makes collaborative groups effective? Given the voluntary nature of these partnerships, membership perceptions of their experiences and the partnership's effectiveness should be important predictors of success. This article provides a preliminary analyses of perceived effectiveness of participants' perceptions of their own partnership, particularly focusing on leadership, conflict management, decision-making dynamics, and the breadth and depth of partnership membership. Members' perceptions that the partnership membership was "sufficiently broad to accomplish objectives" had a negative and highly significant relationship to perceived effectiveness. Members' perceptions about leadership being ethical was positively related to perceived effectiveness while perceptions that the leadership was not effective a keeping the group focused was negatively related to perceived effectiveness.
Using data from the Wisconsin Annual Survey of Home Health Agencies, we describe urban/rural differences for home health care patients. Our findings indicate that urban dwellers are more likely to be home health patients than are rural residents. Urban home health patients are more apt to be nonelderly, male, and have "other conditions" as their primary diagnosis. They are also likely to be more physically dependent and to receive home care longer. Urban home health patients are more typical of long-term care patients, whereas rural patients may be better described as recipients of postacute care, often recovering from diabetes and heart attacks. Possible problems with rural access to home health care are discussed.
Purpose:The situational judgment test (SJT) shows promise for assessing the non-cognitive skills of medical school applicants, but has only been used in Europe. Since the admissions processes and education levels of applicants to medical school are different in the United States and in Europe, it is necessary to obtain validity evidence of the SJT based on a sample of United States applicants.Methods:Ninety SJT items were developed and Kane’s validity framework was used to create a test blueprint. A total of 489 applicants selected for assessment/interview day at the University of Utah School of Medicine during the 2014-2015 admissions cycle completed one of five SJTs, which assessed professionalism, coping with pressure, communication, patient focus, and teamwork. Item difficulty, each item’s discrimination index, internal consistency, and the categorization of items by two experts were used to create the test blueprint.Results:The majority of item scores were within an acceptable range of difficulty, as measured by the difficulty index (0.50-0.85) and had fair to good discrimination. However, internal consistency was low for each domain, and 63% of items appeared to assess multiple domains. The concordance of categorization between the two educational experts ranged from 24% to 76% across the five domains.Conclusion:The results of this study will help medical school admissions departments determine how to begin constructing a SJT. Further testing with a more representative sample is needed to determine if the SJT is a useful assessment tool for measuring the non-cognitive skills of medical school applicants.
The utility of an adolescent drug abuse screening tool was explored in a sample (N = 501) of young gay-bisexual men at risk for HIV-AIDS transmission. The Personal Experience Screening Questionnaire (PESQ; K. C. Winters, 1992) revealed favorable evidence of internal consistency reliability (coefficient alpha) and convergent validity with alternative measures of problem severity and delinquency behaviors. Nearly 20% of the sample had scale scores in the elevated range. The PESQ was highly associated with risky sexual behaviors, including using drugs during sex, engaging in unprotected sex, and having multiple sex partners. Study results are discussed in terms of the content and structural similarity of drug abuse among male gays-bisexuals relative to male heterosexuals and in terms of the need for early drug abuse intervention for young gay-bisexual men engaging in risky sexual behaviors.
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