Stacey McCrary

Sustainability of evidence-based healthcare: research agenda, methodological advances, and infrastructure support

BackgroundLittle is known about how well or under what conditions health innovations are sustained and their gains maintained once they are put into practice. Implementation science typically focuses on uptake by early adopters of one healthcare innovation at a time. The later-stage challenges of scaling up and sustaining evidence-supported interventions receive too little attention. This project identifies the challenges associated with sustainability research and generates recommendations for accelerating and strengthening this work.MethodsA multi-method, multi-stage approach, was used: (1) identifying and recruiting experts in sustainability as participants, (2) conducting research on sustainability using concept mapping, (3) action planning during an intensive working conference of sustainability experts to expand the concept mapping quantitative results, and (4) consolidating results into a set of recommendations for research, methodological advances, and infrastructure building to advance understanding of sustainability. Participants comprised researchers, funders, and leaders in health, mental health, and public health with shared interest in the sustainability of evidence-based health care.ResultsPrompted to identify important issues for sustainability research, participants generated 91 distinct statements, for which a concept mapping process produced 11 conceptually distinct clusters. During the conference, participants built upon the concept mapping clusters to generate recommendations for sustainability research. The recommendations fell into three domains: (1) pursue high priority research questions as a unified agenda on sustainability; (2) advance methods for sustainability research; (3) advance infrastructure to support sustainability research.ConclusionsImplementation science needs to pursue later-stage translation research questions required for population impact. Priorities include conceptual consistency and operational clarity for measuring sustainability, developing evidence about the value of sustaining interventions over time, identifying correlates of sustainability along with strategies for sustaining evidence-supported interventions, advancing the theoretical base and research designs for sustainability research, and advancing the workforce capacity, research culture, and funding mechanisms for this important work.

Evaluation of Experience Corps Student Reading Outcomes

A Mathematica team led by Emily Dwoyer, Kathy Sonnenfeld, and Susan Sprachman provided the data collection services for this study of the Experience Corps (EC) initiative, a program that brings older adults ages 55 and up into public elementary schools to tutor and mentor children who are at risk of academic failure. EC members also help teachers in the classroom and lead after-school enrichment activities. The findings presented in this report demonstrate that students who received EC program tutoring and mentorship showed significant improvements in their reading and comprehension skills and, at the same time, the program was also found to be a low burden to teachers.

The Effect of the Experience Corps ® Program on Student Reading Outcomes

A randomized field trial involving 883 students at 23 schools in three urban cities assessed the effectiveness of Experience Corps® (EC), a program that places older adult volunteers in elementary schools to tutor students who are poor readers. Students were assessed at the beginning and end of the academic year with standardized reading measures. Program effects were analyzed using Generalized Estimating Equations (GEE) to adjust for clustering effects. Findings demonstrated that EC students made statistically greater gains over the academic year on passage comprehension and grade-specific reading skills. The gains were stronger for students who received at least 35 tutoring sessions. These findings indicate that older community volunteers can be effectively deployed to improve reading achievement in low income, ethnic minority children who are at risk of reading failure.

Changes in Activity Among Older Volunteers

Purpose: To explore changes in daily activities associated with high-intensity volunteering, this study assessed activities in a sample of 180 new Experience Corps (EC) volunteers serving low reading students in urban schools. Methods: Level of activity in 15 areas (visiting friends, reading, watching TV, etc.) was obtained at the beginning of this high-commitment volunteer experience and after 9 months of service. Latent class analyses were used to identify activity patterns, and regression analyses were used to identify factors associated with changes in activities. Results: At pre-test, 37% were classified in the low-activity group and were more likely to be first time volunteers, older, non-White, and have less education. At post-test, only 17% were classified as low activity. An increase in activity was more likely to occur for those who were low activity before joining the volunteer program. Implications: These findings demonstrate that increase in activity does occur for less active older adults who join a volunteer program.

Volunteering as a Pathway to Productive and Social Engagement Among Older Adults

Introduction. Research on outcomes of volunteering in later life largely focuses on the health of volunteers. This is in contrast to studies of youth, where attention is directed toward the effects of volunteering on subsequent productive and citizen behaviors. In this study, we examined the effects of volunteering on subsequent social and civic activity of older adults. Method. This study was conducted with volunteers from Experience Corps® (EC), a national program that brings older adults into schools to work with students. Data were derived from a baseline survey of older adults who were new EC volunteers in fall of 2006 and 2007. Follow-up interviews were conducted with 338 volunteers in fall 2010 to capture work, education, and community activities undertaken subsequent to joining EC. Results. Subsequent to joining EC, 16% of volunteers reported that they started a new job, 53% started another volunteer position, 40% started a community activity, and 39% took a class/started educational program. When asked if and how EC participation played a role in their new involvements, 71% said it increased confidence, 76% said it increased realization of the importance of organized activities/daily structure, and more than 40% said they made social connections that led to new involvements. Most reported they were more likely to be involved in advocacy efforts for public education. Discussion. Volunteering among older adults is a means as well as an end—just as it is for young people. Programs can do more to attract and serve older adults by promoting volunteering as a pathway to other engagements, including work, social, and civic activities.

Examining the Effects of New York Experience Corps ® Program on Young Readers

There are hundreds of tutoring programs that utilize community volunteers being implemented across the country; however, there are few rigorous efforts to evaluate their effectiveness. This article presents findings on reading achievement from an evaluation of the New York City Experience Corps®, a program that uses older volunteers to work with students in public elementary schools. Two hundred and eighty-eight first- and second-grade students participated in a pre-test/post-test two group design with randomization to assess the impact of the program on their reading abilities. Reading was assessed using the Phonological Awareness Literacy Screening (PALS) and Early Childhood Literary Assessment System (ECLAS). Results indicate that Experience Corps is effective at improving reading scores. This study provides evidence that older volunteers can be successfully utilized to tutor young readers.

Experience Corps: Benefits of Volunteering

Experience Corps (EC) is a program that brings older adults into public elementary schools to improve academic achievement of students, through one-to-one tutoring, small group academic help and assisting teachers. It has been in existence for over 13 years and currently operates in 20 cities across the country. The Atlantic Philanthropies provided funding to Washington University in St. Louis to conduct a national evaluation of EC. Over 250 members of EC were asked about the benefits that they experienced from participating in the program, and they overwhelmingly reported positive effects on the students and themselves.

Experience Corps Effects on Student Reading

The Experience Corps (EC) program brings adults aged 55+ into public elementary schools to work with children who are at risk of academic failure.

Experience Corps: Methodology of Member Outcomes Study

Experience Corps (EC) is a program that brings older adults into public elementary schools to improve academic achievement of students, through one-to-one tutoring, small group academic help, and assisting teachers. It has been in existence for over 13 years and currently operates in 20 cities across the country. The Atlantic Philanthropies provided funding to Washington University in St. Louis to conduct a national evaluation. Mathematica Policy Research (MPR) provided data collection services.

Research Brief: Experience Corps: Who are the Members?

Experience Corps ® (EC) is a program that brings older adults into public elementary schools to improve academic achievement of students, through one-to-one tutoring, small group academic help and assisting teachers. It has been in existence for over 15 years and currently operates in 22 cities across the country. The Atlantic Philanthropies provided funding to Washington University in St. Louis to conduct a national evaluation of EC.