Health Policy

Finding the Impact in a Messy Intervention: Using an Integrated Design to Evaluate a Comprehensive Citywide Health Initiative

Finding the Impact in a Messy Intervention: Using an Integrated Design to Evaluate a Comprehensive Citywide Health Initiative
American Journal of Evaluation 30 (2009), pp. 495 - 514

Weitzman BC, Mijanovich T, Silver D, and C Brecher
12/01/2009

This article uses the evaluation of the Robert Wood Johnson Foundation’s (RWJF) Urban Health Initiative (UHI), a 10-year effort to improve health and safety outcomes in distressed cities, to demonstrate the strength of an evaluation design that integrates theory of change and quasiexperimental approaches, including the use of comparison cities. This paper focuses on the later stages of implementation and, especially, our methods for estimating program impacts. While the theory of change was used to make preliminary identification of intended outcomes, we used the sites’ plans and early implementation to refine this list and revisit our strategy for estimating impacts. Using our integrated design, differences between program and comparison cities are considered impacts only if they were predicted by program theory, local plans for action, and early implementation. We find small, measurable changes in areas of greatest programmatic effort. We discuss the importance of the integrated design in identifying impacts.

Stirring up the Mud: Using a Community-Based Participatory Approach to Address Health Disparities through a Faith-Based Initiative

Stirring up the Mud: Using a Community-Based Participatory Approach to Address Health Disparities through a Faith-Based Initiative
Journal of Health Care for the Poor and Underserved. Vol. 20.4

Kaplan, S.A.
11/01/2009

The paper provides a mid-course assessment of the Bronx Health REACH faith-based initiative four years into its implementation.

Calorie Labeling And Food Choices: A First Look At The Effects On Low-Income People In New York City

Calorie Labeling And Food Choices: A First Look At The Effects On Low-Income People In New York City
Health Affairs (Millwood). 2009;28(6):w1110-21 (published online October 6; 10.1377/ hlthaff.28.6.w1110)

Elbel, B., Kersh, R., Brescoll, V.L. & Dixon, L.B.
10/06/2009

We examined the influence of menu calorie labels on fast food choices in the wake of New York City's labeling mandate. Receipts and survey responses were collected from 1,156 adults at fast-food restaurants in low-income, minority New York communities. These were compared to a sample in Newark, New Jersey, a city that had not introduced menu labeling. We found that 27.7 percent who saw calorie labeling in New York said the information influenced their choices. However, we did not detect a change in calories purchased after the introduction of calorie labeling. We encourage more research on menu labeling and greater attention to evaluating and implementing other obesity-related policies.

 

Achieving Horizontal Equity: Must We Have A Single-Payer Health System?

Achieving Horizontal Equity: Must We Have A Single-Payer Health System?
Journal of Health Politics, Policy and Law, Vol. 34, No. 4, August 2009 © 2009 by Duke University Press

Gusmano, M.K., Weisz, D. & Rodwin, V.G.
08/01/2009

The question posed in this paper is whether single-payer health care systems

are more likely to provide equal treatment for equal need (horizontal equity) than are multipayer systems. To address this question, we compare access to primary and specialty health care services across selected neighborhoods, grouped by average

household income, in a single-payer system (the English NHS), a multiple-payer system with universal coverage (French National Health Insurance), and the U.S. multiple-payer system characterized by large gaps in health insurance coverage. We find that Paris residents, including those with low incomes, have better access to health care than their counterparts in Inner London and Manhattan. This finding casts doubt on the notion that the number of payers influences the capacity of a health care system to provide equitable access to its residents. The lesson is to worry less about the number of payers and more about the system’s ability to assure access to primary and specialty care services.

Portfolios of the Poor: How the World's Poor Live on $2 a Day

Portfolios of the Poor: How the World's Poor Live on $2 a Day
Princeton, NJ: Princeton University Press. May 2009

Collins, D., Morduch, J., Rutherford, S. & Ruthven, O.
05/01/2009

About forty percent of the world's people live on incomes of two dollars a day or less. If you've never had to survive on an income so small, it is hard to imagine. How would you put food on the table, afford a home, and educate your children? How would you handle emergencies and old age? Every day, more than a billion people around the world must answer these questions. Portfolios of the Poor is the first book to explain systematically how the poor find solutions.

The authors report on the yearlong "financial diaries" of villagers and slum dwellers in Bangladesh, India, and South Africa--records that track penny by penny how specific households manage their money. The stories of these families are often surprising and inspiring. Most poor households do not live hand to mouth, spending what they earn in a desperate bid to keep afloat. Instead, they employ financial tools, many linked to informal networks and family ties. They push money into savings for reserves, squeeze money out of creditors whenever possible, run sophisticated savings clubs, and use microfinancing wherever available. Their experiences reveal new methods to fight poverty and ways to envision the next generation of banks for the "bottom billion."

Evidence-Based Management in Healthcare

Evidence-Based Management in Healthcare
Chicago:  Health Administration Press,

Kovner, A.R., Fine, D.R. & D'Aquila, R.
04/01/2009

Too often in the fast-moving healthcare field, decision makers rely primarily on what has worked before. Evidence-Based Management in Healthcare explains how healthcare leaders can move from making educated guesses to using the best available information to make decisions.

Learn what evidence-based management (EB management) is and how it can focus thinking and clarify the issues surrounding a decision. The book provides a straightforward process for asking the right questions, gathering supporting information from various sources, evaluating the information, and applying it to solve management challenges.

Numerous real-life examples illustrate how the EB management approach is used in a variety of situations, from inpatient bed planning to operating room scheduling to leadership development. These examples also demonstrate the potential costs and benefits of EB management.

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