AoA Program Evaluations and Related Reports
AoA program evaluations insure that: the most relevant data are available to policy makers; programs demonstrate value to the taxpayer; and programs have a track record of results. AoA strives to evaluate programs in an integrated manner combining process, outcome, impact and cost-benefit analysis of evaluation activities. This site provides links to reports and results from these evaluation efforts.
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Completed Evaluations and Studies
Process evaluation of the Chronic Disease Self Management Education Program (CDSME): In September 2011, AoA awarded Contract HHSP233201100492G to IMPAQ International and Altarum Institute. This process evaluation examined state CDSMP programs funded through Communities Putting Prevention to Work: Chronic Disease Self-Management Program, an initiative of the Administration for Community Living/Administration on Aging (AoA) in collaboration with the Centers for Disease Control and Prevention (CDC) and the Centers for Medicare & Medicaid Services (CMS). The research team employed a multi-method approach using multiple qualitative and quantitative data sources. The program data were also used to conduct regression analyses to examine the influence of various factors on participant completion rates. The report provides information about: characteristics of State grantees, CDSMP participants, CDSMP implementation, participant completion rates, site-level data collection, program sustainability, and recommendations for program improvements. The final process evaluation report with Appendices is now available. In addition to the process evaluation, ACL is coordinating with CMS’ efforts in evaluating evidence-based wellness programs. A copy of the CMS report which includes CDSMP outcomes is available at: http://innovation.cms.gov/Files/reports/CommunityWellnessRTC.pdf. For additional information about this grant program please also see the reports created by ACL's technical assistance grantee the National Council on Aging at http://www.ncoa.org/improve-health/center-for-healthy-aging/capping-reports.html
- Serving Elders at Risk: The Older Americans Act Nutrition Programs - National Evaluation of the Elderly Nutrition Program, 1993-1995 (Institute of Medicine of the National Academy of Sciences/National Research Council)
- Real People Real Problems: An Evaluation of the Ombudsman Programs of the Older Americans Act (The National Academies Press)
- Assessment of Title III-D of the Older Americans Act: Disease Prevention and Health Promotion (Research Triangle Institute)
- 2004 Survey of Adult Protective Services: Abuse of Adults 60 Years of Age and Older (National Center on Elder Abuse)
- Information Systems Management Study (NASUA/Westat) – Final Report
- Title III-B Supportive Services Evaluation
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Evaluation of the Aging and Disability Resource Centers (ADRCs)
There are more than 550 ADRC sites across the nation. Since the inception of this initiative, ADRCs have had over 4.8 million contacts with consumers, caregivers, providers and professionals. The focus of the evaluation is to determine the extent to which Aging and Disability Resource Centers (ADRCs) are fulfilling the goal of improving awareness of and access to long term supports and services for older adults and individuals with disabilities and also how well ADRCs are contributing to the overall ACL mission. The process data collection, completed in the fall of 2013, had high response rates at 100% of State-level ADRCs and 84% of local ADRC grantees. The outcome study data collection was completed in the spring of 2014 with more than 600 respondents from 33 sites. The final report is expected to be completed in late FY 2014. Preliminary data from the process evaluation is now available. The results of this evaluation will influence future performance measures and indicators. This work is being completed by IMPAQ International with Abt Associates under contract HHSP233201000692G.
Evaluation of Title III-C Elderly Nutrition Services Program (ENSP)
Under contract HHSP233201200606G, Mathmatica Policy Research, Inc is conducting a process evaluation and cost study of the ENP; the third since the program was created in 1972. The primary research question that the evaluation is designed to answer is, how effective and efficient is the OAA Title III-C Program at addressing the Program’s legislative intent and program goals of helping to keep older Americans healthy and active in their homes and communities and prevent the need for more costly interventions through the provision of healthy meals, social interaction, health promotion, and linking older adults to other appropriate services. This overarching research question addresses two primary and two secondary research domains:
- Program Efficiency: streamlining costs, increasing service cost-effectiveness, leveraging resources and eliminating redundancy;
- Program Effectiveness and Client Outcomes: targeting services to older adults with greatest social or economic need; extent of integration with other home- and community-based long-term care services; client service outcomes such as those associated with a comprehensive and coordinated food and nutrition service system, including health promotion and disease prevention, and maintenance in the community rather than placement in a nursing home; and client satisfaction with services.
- System Infrastructure: policies, resources, use of technology, staff skills, methods of program administration and service delivery.
- Interagency Partnerships: Program coordination and the outcomes of collaborative efforts with other agencies, organizations and stakeholders.
Evaluation of Title III-E National Family Caregiver Support Program (NFCSP)
This national, comprehensive evaluation of the NFCSP will be the first for this relatively new program. Several reports on early implementation activities have been produced but until now the programs have not been mature enough for an evaluation of client outcomes. The Lewin Group, Inc, under award HHSP23337031T, is conducting the evaluation with the overall purpose understanding and documenting the extent to which and how NFCSP goals are being met and if the investment is producing a high quality, cost-effective program. The evaluation seeks to assess the impact of the program at the individual (family caregivers and the persons for whom they care), program, and LTC policy/HCBS system levels.
The evaluation is organized around three broad research areas:
- How does the program meet its goals (legislative, state, local, and provider level)? Do caregivers have easy access to a high quality, multi-faceted system of support and services that meets caregivers’ diverse and changing needs and preferences? What systems need to be in place in order to achieve this?
- What are the outcomes and impacts on caregivers and care recipients? Does the caregiver support provided through the NFCSP have an effect on quality of life and health outcomes for caregivers and care recipients? To what extent has the NFCSP enhanced caregiving? Has it enabled care recipients to remain in their homes and communities when that is the family’s desired outcome?
- Has the program contributed to LTC system efficiency? How is the NFCSP integrated or coordinated with other long-term care programs and what is the effect? Does the NFCSP contribute to any cost savings in the long-term care system by helping families avoid or delay costly institutionalization?
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Evaluation Design Projects
Evaluation design for the Long Term Care Ombudsman Program (LTCOP)
In September 2011 the Administration for Community Living (ACL) awarded contract HHSP233201100500G to NORC at the University of Chicago (NORC) to develop an evaluation study design to better understand and assess the effectiveness of Long-Term Care Ombudsman Programs (LTCOPs). The task included building the evidence base on LTCOPs in order to develop recommendations for a rigorous and comprehensive study design that investigates program efficiency and program effectiveness at multiple levels, including the resident/family, facility, local/state/program, and federal levels. Key tasks of the design process involved the development of a family of four logic models and a set of overarching research questions to guide the evaluation, as well as the identification of data collection tools and data sources that inform those questions. The diversity of proposed activities reflects the ACL’s goals for this evaluation, the commitment to a population health frame of reference, and seven critical LTCOP characteristics that influence design options. The final evaluation design report (PDF, 2MB) was completed in January 2013.
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Evaluation Design for a Global Evaluation of Older American Act (OAA) Services
Under this project, the Administration on Aging (AoA) seeks to study the impact of OAA programs and services, specifically services provided under Title III, on key outcomes including HCBS use, health care use, community tenure, and long-term services and supports (LTSS) expenditures. OAA services and programs are diverse, often integrated and/or provided in combination with other services, funded through multiple funding streams, and administered and delivered by different state and local-level agencies with varying data collection capacity. This design focuses on the impact of services provided through OAA funded HCBS programs authorized under Titles III-B, C, D, and E of the OAA. These programs include a range of supportive services, nutrition services, health promotion and disease prevention programs, as well as services for family caregivers. While the mix and type of services offered differ by state and locality, the vast majority of OAA funding is used for the provision of nutritional services. Proposed research questions include:
- What is the impact of OAA funded HCBS programs and services on:
- Community tenure
- Health care utilization
- Costs of care for older adults (e.g., LTSS, health care costs)
- Physical, mental, and emotional health and wellness (e.g., preventive measures) of care recipients and caregivers
- Unmet needs among older adults
- Caregivers (e.g., strain, burden, depression, health, etc.)
- Coordination of services (e.g., care management)?
- What is the impact of OAA services alone or in combination with services paid for by other sources?
- What is the impact of service mix and intensity on outcomes of interest? [if possible, we will isolate OAA services]
- What subgroups had the most favorable outcomes? (e.g., health conditions, demographics, functional status)
A primary recommendation from the
final evaluation design report
is that the Administration for Community Living (ACL) first facilitate an exploratory study to determine the feasibility and limitations of conducting this evaluation with state OAA data. Such a study will assist ACL in identifying actions needed to better position the states for participation in a nationwide evaluation.
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