Evaluating AIDS Prevention Programs Expanded Edition (1991) / Chapter Skim
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Pages 1-14
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The first designated intervention, the national AIDS media campaign, was established in April 1987 by CDC's National AIDS Information and Education Program. Shortly afterward, Be advertising and public relations firm of Ogilvy & Mather was selected by competitive bid to develop the multiphase campaign of public service announcements, the 1
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We first consider general evaluation and outcome measurement issues (Chapters ~ and 21. We then present issues specific to the three types of AIDS prevention programs: the national media campaign (Chapter 3~; CBO health education/risk reduction projects (Chapter 4~; and the HIV testing and counseling program (Chaps ter 5~.
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notes, however, that because some of the major CDC intervention programs are likely to continue indefinitely, periodic reassessments are warranted to ensure that intervention components continue to be delivered as specified in He program protocol or standards. The nature of the HIV/AIDS epidemic demands an unwavering commitment to prevention programs, and ongoing prevention programs requ~re a similar commitment to their evaluation.
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For example, before implementing a full-scale media campaign of public service announcements, researchers can randomly assign participants to view different preliminary advertising layouts, and self-reported knowIedge, attitudes, and behavioral intentions can then be compared for the different versions. Even when done on a smal1-scale, however, formative evaluation requires financial resources and trained staff.
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To assess the relative effectiveness of different program options in order to determine "what works better," the panel recommends using randomized experiments with alternative-treahnent controls for each of the three major AIDS intervention programs. Because such experiments test alternative or enhanced treatments rather than using a no-treatment control group, they are often more acceptable to participants.
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Therefore the pane] recommends that aD intervention programs, in addition to the general goal of reducing HIV transmission, should have explicit objectives framed in terms of measurable biological, behavioral, or psychological outcomes.
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The panel also recommends augmentation of Be data collection capabilities of the national AIDS hotline. To assess the relative effects of different media campaigns or different program components, the panel recommends randomized experiments of alternative approaches.
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The pane] urges the use of randomized experiments to test the effects of the different CBO projects and to compare the relative effectiveness of different approaches.
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recommends that random~zed controlled experiments be used in outcome evaluations of a small number of important and carefully selected AIDS prevention programs. It is the panel's judgment that well-executed randomized experiments provide the most certainty concerning the effects of these programs.
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~ situations where randomization is not appropriate or feasible, the panel invites serious consideration of nonrandomized studies to evaluate AIDS interventions. The pane]
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The absence of a weary of tested theory or emp~ncal evidence shrinks the basis for the assumptions required by these models. Although He panel is not optimistic about our present ability to 1lse structural equation or selection models and data from nonrandomized studies as He primary strategy for evaluating the effectiveness of AIDS prevention programs, we do believe that such models wiB have a role to play and we suspect that this role may grow in the future.
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7. In addition to the overarching goal of eliminating HIV transmission, He pane} recommends that explicit objectives be written for each of the major intervention programs and that these objectives be framed as measurable biological, psychological, and behavioral outcomes.
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recommends Hat the Public Health Service and other agencies that sponsor the evaluation of AIDS prevention research require the collection of selected subsets of common data elements across evaluation studies to ensure comparability across sites and to establish and improve data validity and reliability. ~ c National AIDS Media Campaign I5.
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The pane} recommends that data be gathered from multiple sources~ncluding testing sites, clients, groups at increased risk of HIV infection, and independent observers-to evaluate five aspects of service delivery: the adequacy of the counseling and testing protocol, the adequacy of the counseling that is actually provided, the proportion of clients that complete the full protocol, the accessibility of services, and He nature of the bamers. if anv to clients Skin ~nr1 completing counseling and testing.
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