Meta-analytic methods were used to synthesize the results of published randomized, controlled-outcome studies of psychosocial interventions with adult cancer patients. Forty-five studies reporting 62 treatment-control comparisons were identified. Samples were predominantly White, female, and from the United States. Beneficial effect size ds were .24 for emotional adjustment measures, .19 for functional adjustment measures, .26 for measures of treatment- and disease-related symptoms, and .28 for compound and global measures. The effect size of .17 found for medical measures was not statistically significant for the few reporting studies. Effect sizes for treatment-control comparisons did not significantly differ among several categories of treatment: behavioral interventions, nonbehavioral counseling and therapy, informational and educational methods, organized social support provided by other patients, and other nonhospice interventions.

Past literature has identified several putative precursors of use, as well as alternative forms of use. However, important shortcomings still exist in previous work on use. In particular, inadequate attention has been given to the underlying processes that may mediate the effects of evaluation on attitude and action. In essence, a key part of the theory of change for evaluation itself is missing. To help fill this gap, we describe a framework designed to capture key mechanisms through which evaluation may have its effects. The framework includes change processes that have been validated in various social science literatures. It identifies three levels of analysis (individual, interpersonal and collective), each with four kinds of processes (general influence, attitudinal, motivational and behavioral). With a more comprehensive view of the mechanisms underlying evaluation's influence, the field can move forward in relation to its understanding and facilitation of evaluation's role in the service of social betterment. K E Y WO R D S : evaluation outcomes; evaluation theory; evaluation use; influence; mechanisms Evaluation is closely tied to the types of programs, policies and practices that affect people's lives, but is itself one step removed from the direct action of these endeavors; therefore most evaluators are drawn to the topic of use. 1 Use is the link between the day-today work of evaluation, on the one hand and those activities that could actually improve the lives of program participants and society, on the other. Concern about use has generated perhaps more empirical research on evaluation than any other topic (e.g.

Articles ABSTRACTAlthough use is a core construct in the field of evaluation, neither the change processes through which evaluation affects attitudes, beliefs, and actions, nor the interim outcomes that lie between the evaluation and its ultimate goal-social betterment-have been sufficiently developed. We draw a number of these change mechanisms, such as justification, persuasion, and policy diffusion, from the social science research literature, and organize them into a framework that has three levels: individual, interpersonal, and collective. We illustrate how these change processes can be linked together to form "pathways" or working hypotheses that link evaluation processes to outcomes that move us along the road toward the goal of social betterment. In addition, we join with Kirkhart (2000) in moving beyond use, to focus our thinking on evaluation influence. Influence, combined with the set of mechanisms and interim outcomes presented here, offers a better way for thinking about, communicating, and adding to the evidence base about the consequences of evaluation and the relationship of evaluation to social betterment.

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Articles ABSTRACTAlthough use is a core construct in the field of evaluation, neither the change processes through which evaluation affects attitudes, beliefs, and actions, nor the interim outcomes that lie between the evaluation and its ultimate goal-social betterment-have been sufficiently developed. We draw a number of these change mechanisms, such as justification, persuasion, and policy diffusion, from the social science research literature, and organize them into a framework that has three levels: individual, interpersonal, and collective. We illustrate how these change processes can be linked together to form "pathways" or working hypotheses that link evaluation processes to outcomes that move us along the road toward the goal of social betterment. In addition, we join with Kirkhart (2000) in moving beyond use, to focus our thinking on evaluation influence. Influence, combined with the set of mechanisms and interim outcomes presented here, offers a better way for thinking about, communicating, and adding to the evidence base about the consequences of evaluation and the relationship of evaluation to social betterment.

Past research has led to conflicting predictions about how hindsight bias is influenced by the self-relevance of an event. Some research suggests that self-relevance will increase hindsight (a) as individuals are motivated to restore a sense of predictability and (b) as self-relevant outcomes elicit sense making, which in turn leads to hindsight. Other research suggests that self-relevance will reduce hindsight, at least in the case of negative outcomes, (a) as individuals seek to avoid blame and (b) as the memories of the reaction to the self-relevant outcomes serve as a memory cue that inhibits hindsight bias. These contrasting predictions were tested by examining retrospections about the foreseeability of a job layoff. Responses were obtained from laid-off workers, from survivors of the layoffs, and from community members. Community members reported more foreseeability than survivors, who in turn reported more foreseeability than laid-off workers. The results held across several analyses, including a regression-discontinuity analysis of survivors and laid-off respondents. The self-relevance of an event such as a layoff seems to reduce hindsight.We contributed equally to this project, and order of authorship was determined by a coin toss.We thank three anonymous reviewers for helpful comments on a previous version of this article.

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