Addressing the Needs of Diverse Survey Populations

Low-Income Families | Adolescents | Women | Racial and Ethnic Minorities |
Individuals with Disabilities | Elderly Individuals with Chronic Disease | Other Groups

Reaching vulnerable groups is one of our nation's biggest challenges. Vulnerable groups may need intensive or specialized services, or they may face difficulties in accessing services. Mathematica has worked with many special populations to assess their needs and help design effective programs.

Low-Income Families

Low-income families can face daunting challenges in accessing health care and vaccinations, enrolling in high-quality child care, and providing a healthy diet for their children. One of our studies is examining intensive and innovative services provided to families through local WIC programs. Some promote breastfeeding, immunization, and well-child care; others address obesity prevention and nutrition education. We are exploring how programs are implemented and can be replicated. We have also conducted national evaluations of the Healthy Start program, which aims to reduce infant mortality and improve maternal and infant health; Early Head Start, which promotes healthy prenatal outcomes for pregnant women, enhances the development of young children, and promotes healthy family functioning; Medicaid and the State Children's Health Insurance Program, which provide health insurance to low-income children; and the Covering Kids and Families Program, which promotes access to health insurance.

Researching Programs for Adolescents

During adolescence, children are discovering their identities, and healthy exploration can be a positive tool in this process. When exploration involves risky behavior, the consequences can be negative. We worked with 12 state coalitions to conduct large-scale surveys on policies to reduce alcohol and tobacco use by minors. We also assessed ways to lower the probability of minors being served alcohol in public settings, with the goal of preventing drunk driving. To address concerns about the public health and other adverse consequences of early sexual activity, we are leading a major national evaluation of Title V abstinence education programs. This large community-based randomized trial assesses outcomes such as sexual activity, pregnancy, exposure to sexually transmitted diseases, and academic achievement. In addition, we are conducting an experimental design evaluation for the Girls, Inc., adolescent pregnancy prevention program, completing baseline and follow-up surveys to measure girls' knowledge and attitudes about sexuality, sexual activity and other risk-taking behaviors, contraception, and pregnancy status.

Examining Women's Unique Needs

Women face unique health issues throughout their life cycle. In addition, effective treatment of some common health conditions involves a different approach for women than for men. We have supported the Well-Integrated Screening and Evaluation for Women Across the Nation (WISEWOMAN) project, a series of demonstrations to improve the health of low-income and uninsured women. For example, we convened an expert panel, produced an electronic resource guide, and are studying best practices. This study includes a literature review on intervention practices, interviews with key informants, in-depth case studies of state projects, and analysis of quantitative and qualitative data. Our other studies have analyzed preventive services for women enrolled in managed care organizations, focusing on the use of data and information systems to improve the delivery of breast and cervical cancer screening. We are also conducting the national evaluation of a project that fosters prevention of domestic violence in 14 states around the United States. We are assessing how the initiative performs in strengthening collaborative activity across domestic violence programs, tracking progress over a five-year period, producing a directory of models available in different states, and making public use data available as a resource.

Analyzing Programs for Racial and Ethnic Minorities

Profound disparities in health and socioeconomic status often occur along racial or ethnic lines. Our extensive work in this area has ranged from studies of broad-based changes in health systems, physician practice patterns, and insurance coverage to evaluations of more specific health programs, such as mammography, prostate cancer screening, nutrition, and chronic disease management programs and their effectiveness for specific racial or ethnic groups. Our research and survey divisions include a large cadre of bilingual staff, and we regularly field large surveys in several languages.

Investigating Initiatives for Individuals with Disabilities

People with disabilities face many challenges in obtaining services. We evaluated consumer-directed care initiatives that provide Medicaid beneficiaries who have disabilities with a monthly allowance to purchase personal care services of their choosing. Similarly, we designed and conducted a survey of home support services for people with physical and developmental disabilities. Another project is surveying thousands of people with disabilities participating in the Ticket to Work Program, which provides vocational rehabilitation and employment services. This longitudinal survey is collecting data on disability and work status, program experiences, health and functional status, health insurance, income, and sociodemographic characteristics. Our large-scale national survey of children with disabilities who are eligible for Social Security Income investigated health status and functional limitations, care utilization, insurance coverage, receipt of services, and other issues.

Assessing Options for Elderly Individuals with Chronic Disease

Finding ways to manage chronic illnesses as the population ages is an important policy concern. We are assessing how disease management programs affect Medicare beneficiaries with congestive heart failure, coronary heart disease, and diabetes. We are also estimating the effects of coordinated care and disease management on patient well-being, satisfaction, and use and cost of Medicare services. Another study of community-based long-term care aimed to link changes in state Medicaid policy to changes in the health care system and to individual well-being. We are further examining these issues in our evaluation of telemedicine services for Medicare beneficiaries with diabetes living in designated health professional shortage areas.

Other Groups

Our survey expertise extends to many other groups, including public officials and program operators; physicians, nurses, and other health care providers; and teachers, principals, and other educators.

Our staff has conducted interviews in a wide variety of settings and pioneered innovative ways of dealing with the special challenges each setting presents. In schools, hospitals, workplaces, reservations, prisons, shelters, and soup kitchens, our culturally competent interviewers have worked with clients to develop effective data collection techniques. We also provide clients with expertise in specialized information collection, including dietary recall, standardized educational testing, medical records abstraction, and specimen collection for substance use detection.

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