Medicaid managed care and racial differences in satisfaction and access.

Many researchers have suggested that the implementation of managed care may lower access to, and quality of, health care services for minorities. However, very little empirical data examining this issue exists. To examine it, the authors used a study design that was both cross-sectional and longitudinal in that they surveyed Medicaid recipients in two counties at two points in time; one of the counties began delivering services through managed care between the two survey periods. Their results indicate that, overall, managed care had neither a positive nor a negative effect on African Americans' access to health care services in either absolute terms or relative to whites'. In addition, race was not found to be associated with satisfaction. However, a Medicaid recipient's race was found to negatively affect his or her access to service under both managed care and fee-for-service systems.

A meta-evaluation of 11 school-based smoking prevention programs.

Eleven school-based smoking prevention programs were subjected to a meta-evaluation. Criteria for the meta-evaluation included: 1) adequacy of the research design, 2) evidence of reliability, 3) evidence of validity, 4) appropriate statistical analyses and interpretations, 5) reporting of effect sizes or practical significance, 6) accounting for attrition, and 7) tracking of fidelity to the program. A three-point rating scale was used ranging from 0-2. Criteria with the best ratings were research design and statistical analysis. The lowest ratings occurred for reliability and validity. The remainder of the criteria ranged between 1 and 2 with minor factors accounting for the difference in ratings. Recommendations include increasing the number of evaluations that included tests of reliability and validity and calculated effect size estimates.

Evaluation of the North Carolina "Baby Think It Over" project.

The North Carolina "Baby Think It Over" (BTIO) evaluation was conducted during spring semester 2000. Data were collected from participating teachers, students, and parents. Twenty-five teachers were selected randomly from different counties in North Carolina. Each randomly selected teacher coordinated the evaluation in conjunction with the intervention. Student surveys determined whether using the BTIO doll changed perceptions and attitudes toward teen parenting. Information also was collected on the veracity of each student's participation based on data provided from the computer in the baby. Surveys were sent home to the parents of participating students so information on communication, disruption of the household, and parenting perceptions could be obtained. Each teacher completed a survey that sought information on topics discussed throughout the intervention, hours of the program, and perceptions of program effectiveness. Parents and teachers were offered participation incentives. Overall, support existed for the BTIO intervention by parents and teachers. Most teachers and parents felt the program was effective at increasing communication about parenting and changing teens' attitudes in a desired direction. Most teachers reported that the intervention was not disruptive to their classes. However, results from student surveys did not reveal the same support. Student changes in attitudes and beliefs about parenting after the intervention were minimal.