Assessing the Field of Post-Adoption Services: Family Needs, Program Models, and Evaluation Issues. Summary Report. 4.1.1 Types of Evaluations Conducted

11/01/2002

Needs assessments. Needs assessments are commonly done, although rarely published for circulation outside the sponsoring state. They describe the kinds of services most needed by families, in terms of recent needs, anticipated needs, priorities, or unmet needs. These studies can be used to document the need for a PAS program and support planning of services to be provided. State-sponsored needs assessments in the field of adoption have generally gathered information from surveys of families who adopted from a states public welfare system and were receiving an adoption subsidy. Contacting these families is facilitated by the fact that states keep contact information for subsidy payment purposes.

Needs assessments and program documentation are more common than outcome evaluations.

Characteristics of children and families served. Regularly collecting data on the characteristics of children and families served is common practice by case managers providing health and social services, often at intake and assessment. In the case of PAS programs, evaluators have used the data gathered by case managers and program staff as part of a process evaluation, yielding a range of potentially useful information to guide PAS program direction and service delivery. Data on families and children served include basic demographic information, history prior to adoption, risk to adoption, family problems and strengths, and family functioning. Clinical instruments are sometimes used to describe child and family functioning, as well as to provide a baseline for outcome evaluations.

Needs assessments and program documentation are more common than outcome evaluations.

Services delivered. The collection of data on service delivery and usage is also fairly common for PAS programs; these data have been used in several PAS evaluations. These data are also critically important to planning PAS programs and funding. Data on services delivered may serve as mediating variables in outcome evaluations, establishing the effect of specific types of services or a threshold service level necessary for effect. If used as part of an outcome evaluation, services need to be documented as they are delivered rather than summarized at case closing. PAS program records are also unlikely to capture services that the family may have received from private providers or other sources not affiliated with the PAS program, which may influence outcomes.

Client satisfaction. An assessment of family satisfaction with services received is a common evaluation approach to improving PAS program staffing and programmatic planning. Most client satisfaction surveys involve the adoptive parent. In several of the case-study states, program staff and evaluators used client satisfaction surveys to guide service delivery. As with needs assessments, the validity of client satisfaction survey data is often limited by poor response rates. Nevertheless, these efforts serve as a useful barometer for program staff and offer an opportunity to maintain communication with adoptive families regarding their needs and preferences.

Outcomes. Outcome evaluations are the least common of all evaluation types. Among challenges inherent in outcome evaluations are the difficulty of demonstrating effects, particularly for less intensive interventions, and the lack of a clear point at which outcomes are to be measured. While outcome evaluations are not necessarily appropriate for all interventions, there is likely to be increasing pressure on PAS programs to document their effectiveness, and increasing interest within the field in comparing alternative service delivery approaches. A variety of measures have been used for outcome assessment, including clinical assessments, changing incidence of events such as adoption disruption or out-of-home placements, goal attainment, or subjective assessments by workers or parents. Child and family clinical assessments offer detailed measures of child and family outcomes for more intensive interventions, with the opportunity for pre/post comparison. There is no consensus yet on which measures are best suited to the needs of adoptive families and most appropriate for different program models.

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