Evaluation of Disability Employment Policy Demonstration Programs

[Excerpt] Having characterized the intermediary approach from published literature, as well as impressions of those who are using this approach in their demonstration projects, and reviewed ODEP’s requirements regarding implementation of the intermediary approach, Westat determined that the intermediary approaches required in the SGAs for the State Intermediary and Faith-based Mentoring demonstration programs have much in common with other ODEP demonstration programs. Other ODEP programs require demonstration projects to partner and collaborate with businesses and business organizations, government, transportation systems, and health and other service providers. They also have goals for ensuring quality and impact and promoting policies to sustain effective practices. The difference, however, is that the State Intermediary and Faith-based mentoring SGAs specifically identified the intermediary approach as the strategy to use. The State Intermediary SGA went even further by delineating specific steps as part of the intermediary process (resource mapping and development of a state plan). Our literature review uncovered a wide variety of examples in which the intermediary approach has achieved useful outcomes on behalf of youth with disabilities. However, all literature we found was descriptive and did not address questions on effectiveness or the most appropriate strategies. Therefore, it is not known whether the intermediary approach is the most fruitful approach for achieving systems change, whether there are some intermediary approaches that are better than others, or whether those approaches would be repeatable and adaptable to other environments. Nevertheless, at our three site visits, we were able to uncover a variety of examples of activities that are consistent with intermediary strategic and operational functions identified in the literature and appear to bode well for success in achieving systems change. Further review of Quarterly Reports and findings from site visits also revealed some systems change already taking place in the systems change focus areas of capacity-building, coordination, consumer choice and employer support, and evaluation of new practices. Subsequent site visits in Phase IV of the independent evaluation are likely to uncover additional examples of intermediary processes, outputs, and outcomes, as well as those practices that appear to be most successful in achieving systems change

Role of Intermediaries in ODEP Youth Demonstration Programs

[Excerpt] All Office of Disability Employment Policy (ODEP) demonstration programs use aspects of an intermediary approach to connect organizations and agencies at all levels in meeting educational and employment goals on behalf of people with disabilities. As part of Phase III of the independent evaluation of ODEP demonstration programs, ODEP asked Westat to conduct an in-depth analysis of the role of intermediaries in building sustained capacity and integration of services of the workforce development system to better serve youth with disabilities. The overriding question in the context of this issue analysis is whether, to what extent, and how the intermediary approach is being used in youth demonstration programs and whether it is effective in creating systems change to better serve youth with disabilities. The following questions were addressed: - What characterizes the intermediary approach? - What are ODEP’s requirements with regard to the use of an intermediary approach by demonstration programs? - What are demonstration project sites’ experiences in using an intermediary approach? &#; What can be said to date on the effectiveness of using an intermediary approach, particularly with regard to systems change

Evaluation of Disability Employment Policy Demonstration Programs

[Excerpt] Since 2001, the Office of Disability Employment Policy (ODEP) has awarded more than $65 million in grants, contracts, and cooperative agreements. Of this, more than$38 million has been awarded to projects under the ODEP Demonstration Program, with about 2 percent directed toward an independent evaluation. The ODEP Demonstration Program consists of a variety of initiatives targeted at both adults and youth with disabilities. All demonstration projects funded under these initiatives are expected to implement and evaluate methods for building the capacity of the workforce development system to better serve people with disabilities. ODEP contracted with Westat, a private research company, to conduct an independent evaluation of its demonstration program. The purpose of the independent evaluation is to provide ODEP with data and information about system change that can be used to assist policy development, decisions, and recommendations, as well as track progress in meeting ODEP’s goals under the Government Performance and Results Act (GPRA). The independent evaluation has three objectives: 1. To provide ODEP with reliable and valid indicators of program effectiveness; 2. To determine the extent to which each program priority area is effective in building workforce development system capacity; and 3. To document local, regional, and/or state systems change that supports program effectiveness. This paper summarizes the issues and accomplishments identified by the evaluation to date in the context of these three objectives

Employer Involvement in Office of Disability Employment (ODEP) Demonstration Programs

[Excerpt] As part of the independent evaluation of ODEP’s demonstration program being conducted by Westat, the Office of Disability Employment Policy (ODEP) asked Westat to provide in-depth analysis of three issues that were identified at site visits and in Quarterly Reports during Phase II of the evaluation. This report provides in-depth analysis on the first issue—employer involvement in adult demonstration programs

Implementation of Practice Guidelines: A Case Study of Hormone Replacement Therapy

grantor: University of TorontoPractice guidelines may improve health care quality and reduce practice variation and costs, but strategies are needed to encourage physicians to comply with guideline goals. In May 1994, the Society of Obstetricians and Gynaecologists of Canada (SOGC) mailed guidelines on hormone replacement therapy (HRT) to Canadian gynaecologists and general and family practitioners (GPs/FPs) and published them in the Society's journal. Distribution was accompanied by a Canada-wide media campaign. The study examined whether the SOGC's implementation strategy increased Ontario women's health care utilization and determined other factors related to physicians' HRT practice. The design consisted of: (1) an interrupted time-series quasi-experiment to examine the association between implementation of guidelines and dispensed prescriptions of estrogen and progestin, gynaecologic visits, and bone density tests; (2) a survey of Ontario gynaecologists and GPs on practice, sources of information, attitude toward guidelines, and demographic factors; and (3) a qualitative assessment of medical literature on HRT, other guidelines, and articles in the popular press and electronic media. Guideline distribution to physicians was associated with increases in new HRT prescriptions dispensed. There is indirect evidence that the communication campaign may have contributed to women asking more questions about HRT. There is evidence of lack of compliance with some guideline recommendations, and the guidelines did not seem to affect bone density testing. GPs/FPs were likelier to have changed their practice than gynaecologists, and a multiple logistic regression analysis found that the odds of a change in practice was greater if physicians thought their discussions with menopausal women on HRT had increased and that more women wanted to use HRT. The qualitative analysis showed that gynaecologists received considerable information on HRT in their medical journal, and other guidelines were not likely to have had an influence on Ontario physician practice regarding HRT. The public was exposed to positive and negative information on HRT, before, after, and during release of the guidelines. It is concluded that the physician arm of the SOGC implementation strategy had an immediate but temporary influence on Ontario physicians and that patient preference needs to be further explored in future guideline implementation strategies.Ph.D