The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #66785

Monica Fox FitzGerald, MHS, Madeleine Shea, PhD, and Claudia Gray, RN, MS. AIDS Administration, Maryland Department of Health and Mental Hygiene, 500 North Calvert Street, 5th Floor, Baltimore, MD 21202, 410-767-5084, mfitzgerald@dhmh.state.md.us

Background: Maryland's Prevention for HIV-Infected Persons (PHIP) Program provided Prevention Case Management (PCM) services to 44 HIV-positive individuals during 2002. Staff has been challenged to measure quantitative changes in sexual and drug-use behaviors among clients. Methods: Participants completed a quantitative HIV-related behavioral risk assessment at baseline and every three months throughout participation in the Program. Qualitative interviews and/or record reviews were conducted with 3 caseworkers and all clients. Results: PHIP Program clients, evenly divided between male and female, were predominantly over the age of 30 (95%), African American (95%), and engaged in HIV services (47% with 4 or more visits). Initial qualitative interviews with caseworkers revealed that quantitative data are not consistent with record reviews and provider perceptions. Baseline classifications made by caseworkers after in-depth interviewing indicated that 81% of clients were injection drug users and nearly 100% were engaged in high-risk heterosexual sex. However, baseline self-reported risk assessment data indicate that 70% of participants had ever injected drugs and 40% had engaged in sex (vaginal, anal, oral) in the previous 3 months. Preliminary investigation suggests that factors that influence response reliability include the extent to which caseworkers are involved in completing quantitative assessments with clients and the stage of the client-provider relationship when the instrument is administered. Conclusion: This session will discuss how qualitative interviewing and case record review have contributed to understanding the progress made by clients engaged in services, and clarify what we can or can not conclude from analyzing the quantitative data based on contradictions analyzed.

Learning Objectives:

At the conclusion of the session, the participants in this session will be able to:
• Identify potential weaknesses of solely collecting quantitative data to capture behavior change in program evaluations.
• Identify strategies for increased validity of quantitative behavioral outcomes by using qualitative research methodologies.
• Recognize the value of designing program evaluations that incorporate mixed methodologies.
• Recognize lessons learned from evaluating PCM activities.

Keywords: Evaluation, HIV Interventions

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.