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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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