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Nutrition

Evaluations Report

ACKNOWLEDGEMENTS

The authors would like to thank the many people who have helped with this project during the past two years. At the U.S. Department of Health and Human Services (DHHS), the Administration on Aging (AoA) project officer, Ed Marcus, and the Assistant Secretary for Planning and Evaluation (ASPE) project officer, Floyd Brown, provided valuable direction and advice. We also benefited from the guidance and support of Jean Lloyd, AoA nutrition officer (and more recently, with the retirement of Ed Marcus, the AoA project officer), and Yvonne Jackson, the Director of the Office for American Indian, Alaskan Native, and Native Hawaiian Programs. We would also like to thank Edwin Walker and Carol Crecy of AoA, who provided valuable comments on evaluation findings during a preliminary briefing of AoA officials. Finally, we appreciate the assistance of Donald Fowles of AoA for providing us with the Census of Population and Housing, 1990: Special Tabulation on Aging CD-ROM, which was used to support the analysis of how well the program targets priority groups of older persons.

Special thanks go out to each of the members of the evaluation's technical advisory group, who met three times during the course of the evaluation to review and comment on the research design, data collection instruments, and the evaluation's findings and analysis methods. We gratefully acknowledge the effort they each made to take time from their busy schedules to review the lengthy documents and to meet with the study team in order to provide comments and to help us draw out the policy implications of the findings. The group's members are Alan Balsam, Leslie Christovich, Connie Codispoti, Walter Ettinger, Robert Hudson, Yvonne Jackson, Diane Justice, Rosalie Kane, Linda LaVine, Robyn Lipner, Marta Sotomayer, and Jane White.

The project also benefited from several other individuals in the aging network. Special thanks go to Bill Moyer, who provided valuable information and advice on many aspects of program operations and administrative structure, and to E. Percil Stanford, for guidance and advice on data collection and analysis regarding program targeting. Jim Whaley provided valuable comments at several points during the course of the evaluation that informed the sample design and design of data collection instruments, as well as interpretation of findings. We also thank Ed Sheehey for making available to us a list of area agencies on aging (AAAs) to serve as a starting point for the development of the AAA sample frame. We would also like to thank Connie Benton Wolfe, Enid Borden, W. Brent McCaleb, Elena Carbone, Eunchil Shim, Ursula Key, and David Leggett for comments during the design phase of the project. We would like to thank Lois Schein of DHHS, Health Care Financing Administration (HCFA), for making available to us the Medicare Beneficiary Files, used to identify eligible nonparticipants for the evaluation.

John Hall developed the sample design and selected the various samples, with assistance from Barbara Cohen, Linda Bandeh, Swatee Nanivadekar, and Jerry Cheng. Chuck Metcalf provided valuable comments on the sample design.

Obtaining the types of information needed for the evaluation required an extensive data collection effort, involving both telephone and in-person surveys of program officials, participants, and eligible nonparticipants. The design and implementation of the overall data collection effort was directed by Rhoda Cohen. Ms. Cohen had direct responsibility for overseeing the training and the day-to-day operations of the field data collection, with assistance from Jim Cashion, Sharon DeLeon, Robin Most, Anne Self, and Susan Weisbrod. The program participant and eligible nonparticipant characteristics/dietary intake interviews were conducted using personal computers and computer-assisted personal interviewing (CAPI). Although Mathematica Policy Research, Inc., (MPR) has a rich history of conducting computer-assisted telephone interviewing (CATI), this was our first application of CAPI technology. We would like to thank the Computer-Assisted Survey Methods Program (CSM), University of California, Berkeley, for making available to us computer programs. We would like to thank Michael Watts, Barbara Cohen, Linda Bandeh, Anne Ciemnecki, and Susan Bard for their work designing, implementing, training, and providing technical assistance to field interviewers on the CAPI instruments developed for the project. The project used the PC-based Nutrition Data System of the Nutrition Coordinating Center (NCC), University of Minnesota, to collect and process the dietary recall and meals offered data. We would like to thank Mary Stevens, Karrin Brelje, Keren Price, Peter Arnmeson, and other staff of NCC for their work in developing the user's manual for the project, training and certifying interviewers, and processing the dietary data. We would also very much like to thank the dedicated group of 40 field interviewers from across the country that skillfully collected the data from meal site directors, congregate and home-delivered participants, and eligible nonparticipants and conducted the facility observations and meals-offered data collection.

Susan Weisbrod oversaw the design, training, and implementation of the State Unit on Aging, Area Agency on Aging, Indian Tribal Organization, and nutrition project telephone surveys. The telephone survey work could not have been successful without the dedication of the senior telephone supervisor Janis Salpeter and the perseverance of her staff of interviewers. Patti Rossi supervised the data quality control work. We would also like to thank Andrew Samson, Charles Nagatoshi, and Valerie Piper, members of MPR's research analyst staff, who skillfully and patiently collected the nutrition project cost and other data.

This report is based on the analysis of several different agency- and person-level data files constructed from primary data collected for the evaluation, as well as secondary data sources, such as Census data. We would like to thank Marianne Stevenson and her staff for entering the agency survey data. We would also like to thank Lara Hulsey, Mona Shah, Christopher Welser, West Addison, and Neeta Sinha for programming assistance. John Hall developed estimates of design effects, with assistance from Swatee Nanivadekar.

John Burghardt reviewed an earlier draft of the report and provided valuable suggestions, which have greatly improved the current version. Joanne Pfleiderer edited the report and thereby made substantial contributions to its clarity. Ms. Pfleiderer was assisted by J.B. Miller. Report production was provided by Debra Jones, with support from Cindy Castro, Monica Capizzi, Marjorie Mitchell, Jill Miller, Denise Dunn, Lynn Beres, Gloria Gustus, and Doreen Ambrose.

The evaluation would not have been possible without the cooperation of study respondents. We would like to thank the agency directors and other staff we interviewed, who graciously contributed their time and expertise to the study, both as survey respondents and as facilitators of the data collection in other levels in the program hierarchy. Last but not least, we would like to thank the congregate and home-delivered participants, and program-eligible nonparticipants, who graciously and patiently contributed their time, so that we might better understand their needs and how the program meets them.

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Last Modified: 12/31/1600