Using Process Data To Explain Outcomes

The purpose of this article is to illustrate the use of process evaluation for understanding study outcomes. Data from the Child and Adolescent Trial for Cardiovascular Health (CATCH), a large school-based field trial, are used. Teacher characteristics, measures of classroom curriculum implementation, and competing influences are linked to changes in dietary knowledge, intentions, and self-efficacy of students in the intervention schools. Multiple regression analyses indicate that teacher charactenstics did not predict program implementation. Teacher characteristics and program fidelity, or the number of modifications made to the classroom curriculum during implementation, had direct and independent effects on student outcomes.

[1]  G. Badger,et al.  Cigarette Smoking Prevention Effects of Mass Media and School Interventions Targeted to Gender and Age Groups , 1995 .

[2]  S. Kelder,et al.  CATCH: Classroom Process Evaluation in a Multicenter Trial , 1994, Health education quarterly.

[3]  Peter H. Rossi,et al.  Evaluating With Sense , 1983 .

[4]  S. Kelder,et al.  Outcomes of a field trial to improve children's dietary patterns and physical activity. The Child and Adolescent Trial for Cardiovascular Health. CATCH collaborative group. , 1996, JAMA.

[5]  Peter H. Rossi,et al.  The Multi-Goal, Theory-Driven Approach to Evaluation: A Model Linking Basic and Applied Social Science , 1980 .

[6]  G. Alan Marlatt,et al.  Self-efficacy in Changing Societies: Self-efficacy and addictive behavior , 1995 .

[7]  W. Rakowski,et al.  Characteristics of participants in community health promotion programs: four-year results. , 1987, American Journal of Public Health.

[8]  D. Altman,et al.  A framework for evaluating community-based heart disease prevention programs. , 1986, Social science & medicine.

[9]  P. Bush,et al.  A process evaluation of the District of Columbia "Know Your Body" project. , 1990, The Journal of school health.

[10]  S. Osganian,et al.  CATCH: Food Service Program Process Evaluation in a Multicenter Trial , 1994, Health education quarterly.

[11]  E. Stone,et al.  Using process data to explain outcomes. An illustration from the Child and Adolescent Trial for Cardiovascular Health (CATCH). , 1998, Evaluation review.

[12]  C. Perry,et al.  The Effects of the Child and Adolescent Trial for Cardiovascular Health Intervention on Psychosocial Determinants of Cardiovascular Disease Risk Behavior among Third-Grade Students , 1996, American journal of health promotion : AJHP.

[13]  R. Lefebvre,et al.  A community education monitoring system: methods from the Stanford Five-City Project, the Minnesota Heart Health Program and the Pawtucket Heart Health Program. , 1993, Health Education Research.

[14]  B. Flay Efficacy and effectiveness trials (and other phases of research) in the development of health promotion programs. , 1986, Preventive medicine.

[15]  Reinhard Fuchs,et al.  Self-efficacy in Changing Societies: Changing risk behaviors and adopting health behaviors: The role of self-efficacy beliefs , 1995 .

[16]  S. Osganian,et al.  Design of Process Evaluation within the Child and Adolescent Trial for Cardiovascular Health (CATCH) , 1994, Health education quarterly.

[17]  H A Feldman,et al.  The effects of the Child and Adolescent Trial for Cardiovascular Health upon psychosocial determinants of diet and physical activity behavior. , 1996, Preventive medicine.

[18]  C. Perry,et al.  School-based cardiovascular health promotion: the child and adolescent trial for cardiovascular health (CATCH). , 1990, The Journal of school health.

[19]  E. Stone,et al.  CATCH: Process Evaluation of Environmental Factors and Programs , 1994, Health education quarterly.

[20]  P. Chalela,et al.  Community level cancer control in a Texas barrio: Part I--Theoretical basis, implementation, and process evaluation. , 1995, Journal of the National Cancer Institute. Monographs.

[21]  A. Bandura Social Foundations of Thought and Action: A Social Cognitive Theory , 1985 .

[22]  Albert Bandura,et al.  Exercise of personal and collective efficacy in changing societies , 1995 .

[23]  C. Perry,et al.  The Child and Adolescent Trial for Cardiovascular Health (CATCH): Overview of the intervention program and evaluation methods , 1992 .

[24]  D. A. Kenny,et al.  The moderator-mediator variable distinction in social psychological research: conceptual, strategic, and statistical considerations. , 1986, Journal of personality and social psychology.

[25]  Carlo C. DiClemente,et al.  Self-Efficacy and Addictive Behaviors , 1995 .

[26]  B. Thompson,et al.  Process Evaluation in the Community Intervention Trial for Smoking Cessation (COMMIT) , 1990, International quarterly of community health education.

[27]  S. Kelder,et al.  Statistical design of the Child and Adolescent Trial for Cardiovascular Health (CATCH): implications of cluster randomization. , 1995, Controlled clinical trials.

[28]  G. Botvin,et al.  Long-term follow-up results of a randomized drug abuse prevention trial in a white middle-class population. , 1995, JAMA.

[29]  D. Mackinnon,et al.  Estimating Mediated Effects in Prevention Studies , 1993 .

[30]  C. Basch,et al.  Avoiding Type III Errors in Health Education Program Evaluations: A Case Study , 1985, Health education quarterly.

[31]  Russell D. Wolfinger,et al.  Analysis Issues in the Evaluation of Community Trials - Progress Toward Solutions in Sas/Stat Mixed , 1994 .

[32]  C. Perry,et al.  Measurement of self-efficacy for diet-related behaviors among elementary school children. , 1995, The Journal of school health.