Coordinated services for children's mental health: a process evaluation.

This article reports on a process evaluation of the Texas Children's Mental Health Plan, a statewide initiative to provide interagency coordinated mental health services to severely emotionally disturbed children and their families. Researchers followed the activities of the state management team and three local sites during the first year and a half of the project's implementation. This article delineates the major positive effects of the plan as well as the facilitating factors and barriers to the development of such an effort.

The contribution of a cultural perspective in understanding and evaluating client satisfaction.

Increasing attention is being given to including measures of client satisfaction as a component in the evaluation of health care services. An understanding of cultural factors that may influence attitudes and behaviors in the health care situation can contribute to the theory and measurement of client satisfaction. Through an examination of some of the cross-cultural literature, this paper delineates dimensions of the health care situation in which clients have been shown to have distinctive preferences, behavioral patterns, attitudes, and treatment expectations. A knowledge of the beliefs and attitudes concerning health and illness that are espoused by a particular cultural group can be a valuable asset in understanding how members of that group will evaluate the delivery of health care services. The examination of how cultural and ethnic differences may affect client satisfaction outcomes points to the necessity of avoiding a global measure of client satisfaction without first examining those particular aspects of health care delivery and of the measurement context that may have a predictable influence on client satisfaction ratings.