Evaluating partnerships for community health improvement: tracking the footprints

Private-public partnerships are increasingly seen as an important mechanism for improving community health. Despite their popularity, traditional evaluations of these efforts have produced negative or mixed results. This is often attributed to weak interventions or an insufficient period of time to observe an impact. This study examines two additional possibilities--the need for a well-articulated shared vision and the governance and management capabilities of the partnership itself. We conducted a midstream process evaluation of twenty-five community partnerships associated with the Community Care Network (CCN) Demonstration Program. We examined how the roles of a common shared vision, strong governance, and effective management influence a partnership's ability to achieve its objectives. The findings, based on both qualitative and quantitative analyses, underscore the importance of membership organizations' perceived benefits and costs of participation and management capabilities to the partnership's progress toward a vision. Based on the qualitative data, six key governance and management characteristics are identified that separate the top performing partnerships from the lowest performing ones. We explore the implications of this research for future evaluations of public-private community health partnerships.     

Implications of Out-of-School Activities for School Engagement in African American Adolescents

The connection between out-of-school activities and school engagement was examined in 140, 6th through 9th grade African American adolescents. Youth’s out-of-school activities were measured with a series of 7 nightly phone calls and focused on time in structured (homework, academically-oriented, extracurricular/sports) and unstructured (watching television, hanging out with peers) activities. School engagement was assessed during a home interview in terms of affective (school bonding), behavioral (school grades), and cognitive (school self-esteem) dimensions. Regression analyses controlling for parents’ education and youth grade in school showed that more time in extracurricular activities was associated with greater school self-esteem and school bonding. In addition, more time spent on homework was associated with greater school bonding for boys. Conversely, more time watching television was associated with lower school self-esteem and school bonding. Aryn M. Dotterer is a postdoctoral scholar at the Frank Porter Graham Child Development Institute at the University of North Carolina. She received her Ph.D. in Human Development and Family Studies from The Pennsylvania State University. Her major research interests include the development of and changes in school engagement and academic achievement among ethnic minority and low income youth from childhood through adolescence with an emphasis on parenting and family-school linkages. Susan M. McHale is a Professor of Human Development and Family Studies at The Pennsylvania State University. She received her Ph.D. in Developmental Psychology from The University of North Carolina at Chapel Hill. Her major research interests focus on children’s and adolescents’ family roles, relationships and activities with a particular emphasis on gendered family dynamics and youth’s sibling relationship experiences. Ann C. Crouter is a Professor of Human Development and Family Studies at The Pennsylvania State University. She received her Ph.D. in Human Development and Family Studies from Cornell University. Her major research interests focus on the implications of parents’ work situations for parents’ and children’s health, psychological development, and family relationships.     

The implementation of complex social policy: Institutional layering and unintended consequences in the National Disability Insurance Scheme

In this article, we identify the unfolding unintended consequences which flow from one instance of policy layering in Australia's National Disability Insurance Scheme (NDIS). We show how use of a causal diagram, which highlights feedback loops and emergent properties, to map complex chains of causal factors can assist policy scholars and policy practitioners to understand the likely direction of change and possible responses. In the case of Australia's National Disability Insurance Scheme, our analysis suggests that the likely direction of change will work against two of the fundamental design features of the NDIS: providing participants with more choice and control, and ensuring all eligible Australians are able to access appropriate services and supports regardless of where they live. Our analysis points to the use of price regulation as the site of potential intervention because of the role it plays in subsequent feedback loops and the development of the two, unwelcome, emergent properties.     

The role of community in facilitating service utilization

Guided by an integrated theory of parent participation, this study examines the role community characteristics play in influencing a parent's decision to use voluntary child abuse prevention programs. Multiple regression techniques were used to determine if different community characteristics, such as neighborhood distress and the community's ratio of caregivers to those in need of care, predict service utilization levels in a widely available home visiting program. Our findings suggest that certain community characteristics are significant predictors of the extent to which families utilize voluntary family supports over and above the proportion of variance explained by personal characteristics and program experiences. Contrary to our initial assumptions, however, new parents living in the most disorganized communities received more home visits than program participants living in more organized communities. The article concludes with recommendations on how community capacity building might be used to improve participant retention.