Using Theories of Action to Guide National Program Evaluation and Local Strategy in the Community Care Network Demonstration

Sofaer, Shoshanna; Bazzoli, Gloria J.; Alexander, Jeffrey A.; Conrad, Douglas A.; Hasnain‐Wynia, Romana; Shortell, Stephen M.; Margolin, Frances S.; Pittman, Mary; Casey, Elizabeth; Ladenheim, Kala; Mauery, D. Richard; Zukoski, Ann P.

doi:10.1177/1077558703259072

Cited by 14 publications

(12 citation statements)

References 10 publications

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“…One major problem in evaluating multi-site community-based projects is that the overall goals and objectives are difficult to conceptualize. While individual projects may claim to share a common vision, they function in very different environments and often approach the same problem in different ways [15]. …”

Section: Methodsmentioning

confidence: 99%

“…Theories of action (TOAs) explain how a program is expected to get from conditions at baseline to a desired future; thereby bridging strategic planning and evaluation [15]. Clarifying underlying assumptions can help to articulate and operationalize hypotheses, research questions, variables of interest and appropriate data collection instrument.…”

Section: Methodsmentioning

confidence: 99%

“…Clarifying underlying assumptions can help to articulate and operationalize hypotheses, research questions, variables of interest and appropriate data collection instrument. TOAs can also help evaluators better understand when expected short-term and long-term outcomes might be observable by examining the order and various levels of anticipated effects [15]. …”

Section: Methodsmentioning

confidence: 99%

“…The Linkage evaluation followed the lead of other multi-site, community-based evaluations [13–15, 20] in recognizing the importance of changing organizational behavior as a prerequisite for changing client/patient behavior. It was hypothesized that effective service linkages could only occur after the collaborating organizations saw each other as offering essential services that could help them better care for their clients/patients.…”

Section: Methodsmentioning

confidence: 99%

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A new model of care collaboration for community-dwelling elders: findings and lessons learned from the NORC-health care linkage evaluation

Kyriacou¹,

Vladeck²

2011

Int J Integr Care

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PurposeProviding care for older individuals with chronic illnesses in the community requires a model of service delivery that takes into account both physical health and social health needs. However, packaging care in this way does not fit into existing service or reimbursement structures in the US, and there are few financial incentives that encourage service coordination. Lack of coordinated care can negatively affect access to high quality, appropriate care, putting seniors' physical and mental health and quality of life at risk, as well as their ability to stay in the community. Supportive Social Programs (SSPs), operating in Naturally Occurring Retirement Communities (NORCs), attempt to increase access to care and enhance care quality for aging residents through outreach and service facilitation. Since their inception in 1986, NORC-SSPs have partnered with local health care providers to address both individual and community-wide health issues; however, each sector continues to operate along functional lines, and on a reactive basis. This article presents findings from an evaluation conducted from 2002 to 2006 looking at the feasibility, quality and outcomes of linking health and social services through innovative NORC-SSP and health organization partnerships.MethodsFour NORC-SSPs participated in the study by finding a health care provider to collaborate on addressing health conditions that could benefit from a biopsychosocial approach. Each site focused on a specific population, a specific condition or problem, and created different linkages to address the target problem. Using a case study approach, incorporating both qualitative and quantitative methods, this evaluation sought to answer the following two primary questions: 1) have the participating sites created viable linkages between the participating organizations that did not exist prior to the study; and, 2) to what extent have the linkages resulted in improvements in clinical and other health and social outcomes?ResultsFindings suggest that immediate outcomes were widely achieved across sites: knowledge of other sector providers' capabilities and services increased; communication across providers increased; identification of target population increased; and, awareness of risks, symptoms and healthy behaviors among clients/patients increased. Furthermore, intermediate outcomes were also widely achieved: shared care planning increased across providers; continuity of care was enhanced; disease management improved; and self care among clients improved. Finally, several linkage partnerships were also able to demonstrate improvements in distal outcomes: falls risk decreased; clinical indicators for diabetes management improved; and inappropriate hospitalizations decreased.DiscussionUsing simple, familiar and relatively low-tech approaches to sharing critical patient information among collaborating organizations, inter-sector linkages were successfully established at all four sites. Seven critical success factors emerged that increase the likelihood that lin...

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

See 2 more Smart Citations

A new model of care collaboration for community-dwelling elders: findings and lessons learned from the NORC-health care linkage evaluation

Kyriacou¹,

Vladeck²

2011

Int J Integr Care

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“…Generating and supporting goal alignment can foster greater commitment and sustain participation of participants Sofaer et al, 2003), which may extend the reach of the alliance in the community. Generating and supporting goal alignment can foster greater commitment and sustain participation of participants Sofaer et al, 2003), which may extend the reach of the alliance in the community.…”

mentioning

confidence: 99%

Fostering change within organizational participants of multisectoral health care alliances

Hearld¹,

Alexander²,

Mittler³

2012

Health Care Management Review

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Decision‐Making Fairness and Consensus Building in Multisector Community Health Alliances: A Mixed‐Methods Analysis

Hearld

Alexander

Bodenschatz

et al. 2013

Nonprofit Mgmnt & Ldrshp

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Given their inherently diverse composition and potentially competing interests, a foundational activity of community health alliances is establishing consensus on the vision and strategies for achieving its goals. Using an organizational justice framework, we examined whether member perceptions of fairness in alliances' decision-making processes are associated with the perceived level of consensus among members regarding the alliance vision and strategies. We used a mixed-methods design to examine the relationship between perceptions of fairness and consensus within fourteen multisector community health alliances. Quantitative analysis found the perceived level of consensus to be positively associated with decision-making transparency (procedural fairness), inclusiveness (procedural fairness), and benefits relative to costs (distributive fairness). Qualitative analysis indicated that the consensus-building process is facilitated by using formal decision-making frameworks and engaging alliance mem-bers in decision-making processes early. Alliance leaders may be more successful at building consensus when they recognize the need to appeal to a member' s sense of procedural and distributive fairness, and, perhaps equally important, recognize when one rather than the other is called for and draw upon decision-making processes that most clearly evoke that sense of fairness. Our findings reinforce the importance of fairness in building and sustaining capacity for improving community health.

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Using Theories of Action to Guide National Program Evaluation and Local Strategy in the Community Care Network Demonstration

Cited by 14 publications

References 10 publications

A new model of care collaboration for community-dwelling elders: findings and lessons learned from the NORC-health care linkage evaluation

A new model of care collaboration for community-dwelling elders: findings and lessons learned from the NORC-health care linkage evaluation

Fostering change within organizational participants of multisectoral health care alliances

Decision‐Making Fairness and Consensus Building in Multisector Community Health Alliances: A Mixed‐Methods Analysis

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