TABLE OF CONTENTS

CHAPTER 1: INTRODUCTION TO SCHOOL-BASED HEALTH CENTER EVALUATION…………………………………………………………………………………...

3

Why Evaluate SBHCs?........................................................................................................ 4 What Has SBHC Evaluation Shown?.................................................................................. 5 Ten Questions a SBHC Evaluation……………………………………………………….. 9 Six Steps in SBHC Evaluation……………………………………………………………. 10 Introduction to Four Main Types of SBHC Evaluation…………………………………... 11 Needs Assessments……………………………………………………………….. 12 Process Evaluations……………………………………………….......................... 13 Outcome Evaluation………………………………………………………………. 13 Impact Evaluation…………………………………………………………………. 14 Chapter 1 Summary…………………………………………………….............................. 18 CHAPTER 2: PREPARING A SCHOOL-BASED HEALTH CENTER EVALUATION…………………………………………………………………………………...

21

Introduction—Using A Logic Model to Form Measurable Goals………………………... 22

Step 1: Identify SBHC Stakeholders……………………………………………... 26 Step 2: Identify the SBHC Environment…………………………………………. 32 Step 3: List Available SBHC Service Cluster…………………............................. 34 Step 4: Link SBHC Interventions to Measurable Outcomes…………………….. 39 Writing Preliminary Evaluation Goals and Objectives…………………………………... 51 Examples of Needs Assessment Goals and Objectives………………………….. 52 Examples of Process Goals and Objectives……………………………………… 53 Examples of Outcome Evaluation Goals and Objectives………………………... 54 Examples of SBHC Impact Evaluation Goals and Objectives…………………... 55 Factors Influencing Evaluation Goals and Objectives…………………………………… 58 Level of the Evaluation…………………………………………………………... 58 Resources for the Evaluation…………………………………………………...... 62 Your Budget……………………………………………………………………… 62 Expertise………………………………………………………………………….. 66 Support………………………………………………………………………….... 66 Protection of Children Participating in School Research………………………… 66

Writing Final Evaluation Goals and Objectives………………………………………….. 76

Chapter 2 Summary……………………………………………………………………….

79

CHAPTER 3: CONDUCTING A NEEDS ASSESSMENT…………………………………... 81 Introduction to Needs Assessment………………………………………………………... 82 Creating a Timeline……………………………………………………………………….. 87 Needs Assessment Methods………………………………………………………………. 89 Gathering Existing Data…………………………………………………………... 89 Collecting New Data…………………………………………………………….... 94 Surveys…………………………………………………………………........ 96

• Existing Surveys………………………………………….. 96 • Considerations When Constructing or Revising a

Survey…………………………………………………….. 99

• Piloting Your Survey……………………………………... 107 • Selecting a Sample……………………………………….. 107 • Next Steps………………………………………………… 109

Focus Groups……………………………………………………………….. 110 • Selecting Focus Group Participant………………………... 111 • Sample Focus Group Outline…………………………….. 112 • Focus Group Checklist……………………………………. 114 • Guidelines for the Recorder………………………………. 117 • Sample Consent Form for Focus Groups…………………. 119 • Piloting Your Focus Groups……………………………… 120 • Guidelines for Note-Based Analysis of Focus Groups…... 120 • Next Steps………………………………………………… 121

Nominal Group Process……………………………………………………… 122 • Selecting Participants for the Nominal Group Process…… 122 • Six Steps in Nominal Group Process……………………... 122 • Piloting the Nominal Group Process……………………… 126 • Next Steps………………………………………………… 126

Key Informant Interviews…………………………………………………...... 127 • Questions for an Interview………………………………... 127 • Selecting Key Informants…………………………………. 131 • Piloting Your Key Informant Interview…………………... 131 • Next Steps………………………………………………… 131

Resource Mapping……………………………………………………………. 132 • Three Steps for Resource Mapping……………................... 132 • Piloting Resource Mapping……………….......................... 135 • Next Steps………………………………………………… 135

Chapter 3 Summary……………………………………………………………………… 136

CHAPTER 4: CONDUCTING A PROCESS EVALUATION……………………………….. 139 Introduction to Process Evaluation……………………………………………………….. 140 Creating a Timeline………………………………………………………………………... 145 Process Evaluation Methods………………………………………………………………. 147 Quantitative Data Collection Methods…………………………………………… 149

• SBHC/Clinical Data………………………………………. 149 • Survey Data……………………………………………….. 154

Qualitative Data Collection………………………………………………………………. 156 Chapter 4 Summary……………………………………………………………………… 158 Next Steps……………………………………………………………………………….. 158 CHAPTER 5:CONDUCTING AN OUTCOME OR IMPACT EVALUATION……………. 161 Introduction to Outcome and Impact Evaluations………………………………………… 162 Creating a Timeline……………………………………………………………………….. 164 Outcome and Impact Evaluation Methods……………………………………………….... 167 Choosing and Appropriate Study Design…………………………………………. 167 Non-Experimental Studies………………………………………………… 169

• Post-Test Only Studies……………………………………. 169 • Pre-Test/ Post-Test Studies……………………………….. 170

Quasi-Experimental Studies………………………………………………. 171 • Cohort Studies…………………………………………….. 171 • Case-Control Studies……………………………………… 174

Experimental or Intervention Studies…………………………………….. 176 Sampling………………………………………………………………………………….. 181 Estimating Your Sample Size……………………………………………………… 181 Sampling Methods……………………………………………………………......... 184

• Random(Probability) Sampling…………………………... 184 Simple Random Sampling…………………………. 185 Stratified Random Sampling……………………….. 185 Systematic Random Sampling……………………... 186 Cluster Random Sampling ………………………… 186

• Non-Random(Purposive) Sampling…………..................... 186 Matched Schools…………………………………... 186 Matched Students………………………………….. 187 Quota Sampling………………………………….... 187 Convenience Sampling……………………………. 188

Snowball Sampling or Peer-Generated Comparison Groups……………………………………………..

188

Data Collection Methods…………………………………………………………………. 189 Core Data Elements for Outcome and Impact Evaluation………………………… 189

• Baseline Data……………………………………………... 189 • Clinical Data……………………………………………… 189

Existing Data Sources…………………………………………………………….. 192 Questionnaires and Interview…………………………………………………….. 195 Tips for Outcome/Impact Data Collection……………………………………….. 195 Piloting Your Outcome/Impact Evaluation………………………………………………. 199 Chapter 5 Summary………………………………………………………………………. 200 Next Steps…………………………………………………………………………………. 200 CHAPTER 6: COMPILING AND ANALYZING YOUR DATA…………………………… 203 Different Types of Data………………………………………………………………….. 204 Compiling and Analyzing Quantitative Data……………………………………………... 207 Compiling and Analyzing Quantitative Data Without Computers………………….......... 211 Compiling Quantitative Data……………………………………………………… 211 Analyzing Quantitative Data………………………………………………………. 212

• Steps in Analyzing Single Variables……………………………… 212 • Analyzing the Relationship Between Two Variables……….......... 218

Compiling Quantitative Data with Computers…………………………………………….. 220 Entering Data Into a Database……………………………………………………. 220 Coding Keys………………………………………………………………………. 221 Entering an ASCII File into a Statistical Software Package……………………… 224 Analyzing Quantitative Data with Computers……………………………………………. 225 Reporting Frequencies for Different Types of Data…………………………….. 226 Overview of Statistical Tests for Different Types of Data……………………. 226 Interpreting Measures of Statistical Significance……………………………….. 228 Explanation of Confounding Variables…………………………………………. 229 Nominal Methods………………………………………………………………... 231

• Chi-Square Analyses………………………………………............ 231 • McNemar Test…………………………………………………….. 233 • Cochran’s Q Test…………………………………………………. 235 • Logistic Regression Analyses…………………………………….. 236

Non-Parametric Methods……………………………………………………….. 243 • Mann-Whitney U…………………………………………………. 243

• Kruskall Wallis ANOVA…………………………………………. 245 • Wilcoxon Matched-Pairs Signed Rank…………………………… 247

• Friedman Matched Samples……………………………… 250 • Spearman Correlation Coefficient………………………... 252

Parametric Methods……………………………………………………………. 253 • 2 Independent-Samples T-Test…………………………………… 253 • One-Way ANOVA……………………………………………….. 255 • Paired Samples T-Test……………………………………………. 258 • Pearson’s Correlation Coefficient………………………………… 259 • Multiple Linear Regression……………………………………….. 260

Chapter 6 Summary-Negative and Positive Results ………………………………………. 264 Next Steps…………………………………………………………………………………. 265 CHAPTER 7: ACTING ON FINDINGS………………………………………………………. 267 Creating and Evaluation Summary………………………………………………………… 269 Providing Stakeholders with Feedback-General and Personalized Reports……………….. 271 Feedback to the SBHC School-Meetings, Letters, Ceremonies, Reports……………......... 272 Feedback to Professional Organizations-Conferences and Publications………………….. 273 Dissemination to the Larger Community………………………………………………….. 275 Legislation………………………………………………………………………………… 279 Sharing Your Results with Local, State, and National SBHC Organizations……………... 282 Chapter 7 Summary……………………………………………………………………….. 283 EVALUATION MANUAL SUMMARY……………………………………………………… 285 BIBLIOGRAPHY……………………………………………………………………………….. 287 APPENDICES………………………..…………………………………………………………. 291 Appendix A: Glossary to Terms…………………………………………………………... Appendix B: Resource List……………………………………………………………….. Appendix C: Surveys for Elementary School-Student and Parent Surveys……………….. Appendix D: Surveys for Middle and High School- Teen and Parent Surveys ................... Appendix E: SHO!!! Commands……………..………………………………………........ Appendix F: Acting on Results: Examples………………………………………………...