Evaluation: it makes a difference
Howard, M.
Bulletin of the new York Academy of Medicine 67(6): 595-605
1991
ISSN/ISBN: 0028-7091 PMID: 1802332 Document Number: 321987
This case study relates how evaluation was important in the evolution of the Teen Services Program at Grady Memorial Hospital, Atlanta, Georgia, a program set up in conjunction with Emory University. As part of a conference address, it is directed to efforts focusing on low income black youth. The teen program approach uses case management with counselors trained in youth social work in the delivery of family planning services tailored to the special needs of adolescents. Services usually begin when the young person is pregnant. A description of features which distinguish the programs is provided for the family planning component, the initial outreach program in the public schools for human sexuality education, the redesigned outreach education program, and the development of new curriculum materials based on evaluation reports which emphasize postponing sexual involvement and using older youth to positively influence younger youth in making responsible decisions. The Teen Services Program, for example, provides 3-month followup until the student is finished school, which originally was a 1-year followup. During the 1970s the expansion of the program into public health and sex education occurred; all 8th graders received instructional resources and much attention was devoted to correcting misinformation. Evaluation in the early 1980s found higher levels of knowledge and risks of sexual involvement among students compared with neighboring school systems of higher socioeconomic status. The knowledge behavior connection had not been bridged yet, however. Another evaluation was conducted on patient satisfaction with in-hospital services, and in smoking prevention among youth. The most frequent need revealed in the survey was how to say no without hurting someone's feelings. The need became apparent that those not desiring sexual intercourse were without services. A revised program was instituted and the findings showed that after 1 1/2 years, there was a 33% reduction in sexual involvement for boys and girls and a greater likelihood of using contraceptives. Hospitals records also revealed a reduction by 33% of births among low income youth. 1 in 10 children before the 8th grade had had intercourse, and those sexually involved were also more likely to be smoking and drinking. A new effort is underway to involve parents in communicating important messages. Evaluation helped to distinguish between those features of the program that worked from those that did not. It increased cooperation and commitment and innovative and multiple approaches. Commitment or staying power was increased, as well as understanding the breadth and depth of the issues and the need for total community involvement.