Leveraging healthcare delivery system leadership to improve adolescent reproductive health outcomes: lessons learned (so far) from the CDC/OAH National Teen Pregnancy Prevention Initiative

Contraception ◽  
2013 ◽  
Vol 88 (2) ◽  
pp. 311
Author(s):  
R. Hallum-Montes ◽  
D. Middleton ◽  
L. Avellino
2020 ◽  
pp. 0193841X2097527
Author(s):  
Jean Knab ◽  
Russell Cole

Purpose: This case study discusses Mathematica’s experience providing large-scale evaluation technical assistance (ETA) to 65 grantees across two cohorts of Teen Pregnancy Prevention (TPP) Program grants. The grantees were required to conduct rigorous evaluations with specific evaluation benchmarks. This case study provides an overview of the TPP grant program, the evaluation requirements, the ETA provider, and other key stakeholders and the ETA provided to the grantees. Finally, it discusses the successes, challenges, and lessons learned from the effort. Conclusion: One important lesson learned is that there are two related evaluation features, strong counterfactuals and insufficient target sample sizes, that funders should attend to prior to selecting awardees because they are not easy to change through ETA. In addition, if focused on particular outcomes (for TPP, the goal was to improve sexual behavior outcomes), the funder should prioritize studies with an opportunity to observe differences in these outcomes across conditions; several TPP grantees served young populations, and sexual behavior outcomes were not observed or were rare, limiting the opportunity to observe impacts. Unless funders are attentive to weaning out evaluations with critical limitations during the funding process, requiring grantees to conduct impact evaluations supported by ETA might unintentionally foster internally valid, yet underpowered studies that show nonsignificant program impacts. The TPP funder was able to overcome some of the limitations of the grantee evaluations by funding additional evidence-building activities, including federally led evaluations and a large meta-analysis of the effort, as part of a broader learning agenda.


Complexity ◽  
2018 ◽  
Vol 2018 ◽  
pp. 1-24 ◽  
Author(s):  
Inas S. Khayal ◽  
Amro M. Farid

In recent years, healthcare needs have shifted from treating acute conditions to meeting an unprecedented chronic disease burden. The healthcare delivery system has structurally evolved to address two primary features of acute care: the relatively short time period, on the order of a patient encounter, and the siloed focus on organs or organ systems, thereby operationally fragmenting and providing care by organ specialty. Much more so than acute conditions, chronic disease involves multiple health factors with complex interactions between them over a prolonged period of time necessitating a healthcare delivery model that is personalized to achieve individual health outcomes. Using the current acute-based healthcare delivery system to address and provide care to patients with chronic disease has led to significant complexity in the healthcare delivery system. This presents a formidable systems’ challenge where the state of the healthcare delivery system must be coordinated over many years or decades with the health state of each individual that seeks care for their chronic conditions. This paper architects a system model for personalized healthcare delivery and managed individual health outcomes. To ground the discussion, the work builds upon recent structural analysis of mass-customized production systems as an analogous system and then highlights the stochastic evolution of an individual’s health state as a key distinguishing feature.


2003 ◽  
Vol 4 (3) ◽  
pp. 323-335 ◽  
Author(s):  
Belinda M. Reininger ◽  
Murray Vincent ◽  
Sarah F. Griffin ◽  
Robert F. Valois ◽  
Doug Taylor ◽  
...  

Author(s):  
Staci Wendt ◽  
Ashley Boal ◽  
Sarah Russo ◽  
Jonathan Nakamoto

Despite relatively high rates of teen pregnancy and sexual risk-taking among justice-involved youth, there is a scarcity of programming to help these youth become better informed about sexual health and decision making. The lack of adequate programming may in part be due to challenges that exist when trying to develop and implement programs in juvenile justice settings. Project With is a sexual risk avoidance intervention that includes storytelling and mentoring components and is currently being implemented within a large juvenile justice agency in California. This paper shares the lessons learned through implementation of the Project With program at five juvenile justice facilities. These lessons focus on the relationships, processes, and logistics that facilitated and impeded implementation, as well as aspects of the Project With design that promoted youth engagement. In particular, insights about the importance of leveraging relationships, gathering buy-in at multiple levels, understanding the system, and allowing for flexibility are highlighted. A checklist is included to support other program developers and researchers who seek to create, implement, and study teen pregnancy prevention programming for justice-involved youth.


2014 ◽  
Vol 05 (15) ◽  
pp. 1396-1404 ◽  
Author(s):  
Caroline Leeds ◽  
Kaia Gallagher ◽  
Tara Wass ◽  
Amber Leytem ◽  
Judith C. Shlay

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