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Running head: ANSWERS MATERNITY SUPPORT SERVICES 1

Evaluation Report: Answers Maternity Support Services

Zarina Ismagilova, Ashley Manzoni, Sierra Thomas, Emily Siltman

Western Washington University

Community Need

ANSWERS MATERNITY SUPPORT SERVICES 2

When examining national infant mortality rates on a global scale, the United States, an

otherwise developed nation, has a history of disappointing and dangerous incidences of infant

mortality. When compared to the mortality rates in Japan, the rate of the U.S. was nearly double

when it hit 8.9 deaths per 1,000 live births in 1991 (Norwood, 1994). Though data depicting

infant mortality rates in the U.S. display a somewhat steady decline throughout history, the rates

within the past decade are less than encouraging. Leveling out between eight and six infant

deaths per 1,000 live births between the years of 1994 and the most recent data of 2009, the

plateau in mortality rates demonstrates that whatever progress was made has since slowed

considerably (National Center for Health Statistics, 2014). Though many factors can contribute

to infant mortality including preterm delivery and low birth weight resulting from inadequate

intrauterine growth, many of these contributors can be prevented with sufficient prenatal care

(Norwood, 1994). The success of prenatal care as a contributor to lower infant mortality rates

can be demonstrated by “a review of the list of countries with infant mortalities lower than that

of the United States [which] reveals that easily accessible prenatal care is available to women in

those nations” (Norwood, 1994, p. 467).

Despite the fact that prenatal care is esteemed for being a successful and cost-effective

method for improving pregnancy and childbirth outcomes for all demographics of the

population, lasting healthcare inequities limit the access to this type of care for some women.

Evidence has shown that in the state of Washington in the year 2001 one out of six infants

(17.5% of live births) was born to a mother who received inadequate prenatal care (National

Center for Health Statistics, 2014). Inadequate prenatal care, as defined by the Adequacy for

Prenatal Care Utilization Index, is pregnancy-related care that begins in the fifth month of

gestation or later, or care that is received less than half of the appropriate, suggested amount


(National Center for Health Statistics, 2014). A geographic representation of the differing rates

of inadequate care in the Washington counties (Appendix A), demonstrates that in Whatcom

County between 15.2 and 18.9% of live born infants were born to mothers who received

inadequate prenatal care between the years of 2008 and 2011 (National Center for Health

Statistics, 2014). The populations most at risk for receiving inadequate prenatal care in the

United States are young women in their teen years, unmarried women, and women of color;

specifically Hispanics, African Americans, and Native American women (Norwood, 1994).

Maternity Care Access Act & First Steps

Though the crisis of inadequate prenatal care in the United States continues, this issue

“has been recognized and responded to by many levels of society” including federal and state

levels of legislation (Norwood, 1994, p. 468). Increases in funding for maternity care programs,

outreach, the institution of new systems for care delivery, and arrangements for social and

educational support services are some of the ways society has responded to this crisis. One

example of the reaction to this crisis is the Maternity Care Access Act, passed by the Washington

State Legislature in 1989, which effectively expanded the Medicaid eligibility criteria to include

pregnant women within 185% of the federal poverty line (“Maternity Support

Services(MSS)/Infant Case Management(ICM) Resource Guide,” 2012). The Access to

Maternity Care Committee, established in 1988, worked to add $18.9 million to the funding of

programs that would increase the availability and use of prenatal care for populations that had

limited access to these support services (Norwood, 1994).

One of the programs with increased funding was First Steps which offers two levels of

support interventions for pregnant women who qualify for Medicaid: Maternity Support Services

(MSS) and Maternity Case Management (MCM). While the MSS program provides eligible


women throughout their pregnancy and for two months postpartum with “preventive health

services designed to supplement medical visits and include screening, assessment, education,

intervention, and brief counseling,” the MCM program is designed to meet the needs of women

needing more targeted support (“MSS/ICM Resource Guide,” 2012, p. 7). Women who receive

MCM services are “considered to be at increased risk for a poor pregnancy outcome and

parenting difficulties” and typically exhibit the following factors: teens younger than 17, women

who did not graduate from high school, women with substance abuse or mental health issues,

women who do not speak English, and women with a history of child abuse or neglect

(Norwood, 1994, pp. 468-469). Once clients are referred to a First Steps agency approved by the

Health Care Authority by either self-referral or from healthcare providers or social support

workers, the referred-to agency decides what level of support the client needs and designs their

treatment plan accordingly. This freedom for the First Steps agency to tailor their clients’ support

plans allows each agency to respond to the needs that are specific to their clients and their

community.

The ability of the First Steps agency to respond to and interact with their community is

crucial as the MSS program operates on the Interdisciplinary/Interagency Model of Care

(depicted in Appendix B) (“MSS/ICM Resource Guide,” 2012). In this care model, the client is

attended by an interdisciplinary team within the agency in conjunction with targeted care offered

by support providers outside of the First Steps agency to which MSS clients are referred. While

each team member within the First Steps agency contributes unique skills, knowledge, and

experience to the client’s MSS team, linkage to other service providers in the community rounds

out the provision of care. This linkage to community systems is “a critical part of the First Steps

mission, the First Steps agency and its employees need to make contact and coordinate with


other service providers involved in the client’s life” in order to ensure that all of the client’s

needs are met (“MSS/ICM Resource Guide,” 2012, p. 15).

Review of Effectiveness of First Steps Programs

The success of First Steps Programs in reducing negative pregnancy and birth outcomes

and MSS provision specifically have been assessed in several empirical studies. In a study by

Norwood (1994) to measure the success of First Steps participants versus women that did not

participate in First Steps programs but were eligible to do so, a group of 220 postpartum women

who received Medicaid during pregnancy were asked to complete structured interviews and to

provide a measure of their perceived support using the Social Support Apgar tool. Of the 220

participants, all received adequate prenatal care and had favorable pregnancy outcomes, and

almost two-thirds of the women participated in at least one First Step Program and reported that

they found these programs helpful (Norwood, 1994). When participation in the First Steps

programs was analyzed for effectiveness in preventing negative pregnancy outcomes considering

factors such as gestational age at birth, onset of prenatal care, and NICU utilization, however, the

only legitimate impact discovered was that more program participants quit smoking during their

pregnancies (Norwood, 1994). This evidence shows that though the First Steps participants

enjoyed the programs they utilized, the actual success of positive pregnancy outcomes cannot be

entirely attributed to the participation in First Steps programs as nonparticipants had similar

success.

Similar results were found in a study by Farrow, Baldwin, Cawthon, and Connell (1996)

which measured the impact of maternity services programs on prenatal care use among Medicaid

eligible women. This study utilized client-based data from the First Steps Database and birth

certificate data for babies born in Washington state between August 1989 and December 1991 to


Medicaid-covered women (Farrow, Baldwin, Cawthon, & Connell, 1996). From this data, the

researchers observed that the women participating in either MSS or MCM programs were

typically unmarried women, teens, smokers, and women considered at risk for having babies

with a low birth weight (Farrow, et al., 1996). Another interesting finding from this research was

the conclusion that a reliable predictor of the participants’ receipt of MSS and MCM programs

was the type of prenatal care provider seen, suggesting that maternity care providers are a strong

referral source for First Steps programs (Farrow, et al., 1996). From this conclusion, the

researchers suggested that efforts be made by First Steps agencies to inform care providers about

the availability of MSS and MCM services so as to encourage providers to refer their patients to

these helpful services and to make sure that the programs are utilized properly (Farrow, et al.,

1996). The final conclusion of this study, similar to the aforementioned study, was that women

who participated in MSS were more likely that non-participants to receive an adequate amount of

prenatal visits, however, this conclusion cannot be entirely attributed to First Steps programs as

many of the study participants were already receiving prenatal care before they began MSS

programs (Farrow, et al., 1996, p. 107).

The following report details the process of evaluating the MSS program offered by a First

Steps agency in Whatcom County, Answers. The evaluation team focused on the success of the

referral partnerships that Answers has achieved and is sustaining within the community. This

aspect of First Steps organizations, described above as the Interdisciplinary/Interagency Model

of Care, is crucial to meeting the distinct needs of each MSS client. The details of the methods

taken to complete this evaluation and analyze the findings, as well as the results of the process,

are described below.

Description of Evaluation Activities


The Initiative

The specific purpose of the Answers MSS program is to foster positive birth outcomes

for mothers and their children through resource referral, short-term case management, and

breastfeeding services (K. Cain, 2014, personal communication, February 5th, 2014). Due to

funding restrictions, clients are limited to a maximum of seven hours staff service; therefore,

referrals to local external resources enable Answers’ to meet clients’ diverse needs. Answers

focuses on serving the dynamic needs of each client, determined on an individual basis. For

example, mothers in recovery from substance abuse may spend most of their seven hours with

Answers focused on case management and/or referrals out for housing or counseling specific to

this unique need. In other cases where the mother has stable housing and no substance abuse

history, their time may be spent with Answers’ breastfeeding services. Since the specific needs

of each family differ case to case, an individual’s relationship with Answers may have a different

focus than another individual’s experience.

Logic Model

The initiatives theory of change is to have healthy moms, babies, and families, and with that,

positive birth outcomes for Medicaid recipients. Answers partnerships and resources consist of

local pregnancy clinics, interpreters for bilingual clients, social service agencies, health care

providers, community resource centers and so forth. Answers would like to expand their

collaboration with other organizations in order to contribute to a greater outreach and provide

additional resources to current and future clients. See Logic Model below.


Answers Maternity Support Services ProgramProgram Goal: To have healthy moms, babies, and families and have positive birth outcomes for Medicaid recipients.

Inputs/Resources Activities Outputs Short-term Outcomes Medium-term Outcomes

Long-term Outcomes

Impact

Planned Parenthood

SeaMar Private Doctors Peace Health

Hospital & Family Practice

Interpreters DSHS Midwives Whatcom

County Health Department

WC Technical College

BOGA Insurance

providers Whatcom

county pregnancy clinic

Develop partnerships with organizations that might be future linkages

Outreach to clients

7.5 hours of case management time with each client

Intake/assessment Pregnancy tests Medical

insurance sign-up Family Planning Clients have

access to continued resources up to 2 months postpartum

Clients gain knowledge about and access to local resources/ organizations and their services.

Clients report gaining skills and knowledge.

Clients utilize community resources.

Clients report positive birth experiences (i.e. healthy mothers, healthy babies, reduced stress, stability).

Clients gain tools and knowledge regarding future family planning.

Better birth outcomes for mothers and babies in Whatcom County.


Purpose of Evaluation

The purpose of this evaluation is to examine the process of how Answers engages in

outreach to potential clients. For this, our research team came up with evaluation questions that

surrounded the main goal of improving outreach with partnered agencies based on the needs of

the organization at hand. The evaluation questions are as follows:

1. How can Answers improve outreach by engaging their partners?

2. How can Answers improve outreach through marketing?

3. How can Answers improve outreach through learning from client interactions/ evaluations?

Data Collection Strategy

In order to productively and efficiently collect data based on these evaluation questions,

we collected quantitative data from two sources. We did an analysis of existing surveys provided

by Answers and we developed a quantitative survey to distribute to referring partners.

Answers existing surveys

Our stakeholder, founder and Executive Director of Answers, Karla Cain, was contacted

after MSS identified its goals and objectives as a program. A collaboration between Cain and our

research team commenced in order to decide what area needed to be evaluated. Cain then

provided us with the existing surveys that had been completed by clients of MSS in Whatcom

County. For these existing surveys we chose to evaluate the previous experiences of the clients

and how they were specifically referred to Answers MSS services, and it what ways they’re

services were helpful. Some of these services included: dental services, car seats, breastfeeding

etc.

Evaluation Surveys


These surveys purpose was to focused on how well the community was hearing about

Answers, as well as how many times per month that other organizations were making referrals to

their services. Each survey was provided with an area asking the organizations name, their

position at said organization, and if they were familiar with MSS along with multiple questions

geared toward how MSS and Answers markets themselves, is in communication with other

agencies if at all etc., which allowed us to analyze how affective and consistent Answers is in

these areas from the perspective of potential or already referring organizations.

Sample Selection

Cain provided us with a list of collaborating organizations that Answers already had in

Whatcom County. Of this list of agencies our research team chose a targeted sample to work

with.

The agencies provided were the Whatcom County Health Department, Bellingham

Obstetrics and Gynecological Services (BOGA), Planned Parenthood, Interfaith Community

Health Center, Women Infant and Children (WIC), Peace health Family Practice and Support

Services, as well as several local midwifery practices. These organizations then became our

sample for the evaluation process due to the experience and relationship each agency has with

Answers. These agencies were thought to give the research team the most substantial data

collection and results based on their involvement with Answers.

The community manager of the Whatcom County Health Department was contacted for

resources and contacts to these organizations. A contact list was provided, and we contacted all

partnerships accordingly. Each individual team member then contacted specific agencies from

our sample and administered the survey that was conducted by our research team, if the agency

chose to comply. All organizations mentioned above were emailed and/or phone contacted by


our research team. With trial and error, we were able to get four organizations to participate in

completing a survey out of the original larger sample of agencies.

Instrument Development

The instrument that was decided to be most appropriate and productive for this evaluation

was a survey. To answer the research questions: How can Answers improve outreach by

engaging their partners? , How can Answers improve outreach through marketing? , and How

can Answers improve outreach through learning from client interactions/ evaluations? We

developed a quantitative survey that consisted of seven questions geared toward our research

questions developed previously. The questions were geared toward agencies that are in contact

with Answers and that reciprocally refer clients to one another. The survey included questions

about how many times the partnering agencies were referring clients to MSS, under what

circumstance they refer to them, what marketing material and/or resources were provided and

what Answers MSS could do to make the referring process easier. The piloting process consisted

of collaborating with our professor Hope Corbin to improve our structure and refine our

approach within the survey. See Appendix C for the complete survey.

Data Analysis

Answers existing surveys.

The beginning of our data analysis consisted of meeting with Cain to discuss and receive

surveys that Answers has been administering to clients after they have sought services. We then

coded both the quantitative and qualitative data from these surveys. For the quantitative data, we

focused on the question on the Answers survey that asked, “What resources have you used since

your contact with our agency?” The list included options such as: WIC, Child Health, Legal

(paternity), Food Stamps, Job Services Center, Family Planning, etc. Our research team utilized


Excel software to analyze our data. All selected options (a check mark) were coded as “1,” and

all unselected responses were coded as “0.” Qualitative data written in the “other” sections (any

additional resources that were not listed in the survey question) were coded and analyzed for

themes . Using these analyzing methods the research team was able to discover frequencies and

percentages of how often certain resources were utilized and in what ways Answers is helpful to

their clients. (See Appendix E for a visual representation of these findings.)

Evaluation surveys

We coded and analyzed the surveys distributed to referral agencies similarly to the

existing client surveys we received from Answers. The survey consisted of seven questions each

given numerical value based on the answers they chose. The survey consisted of several methods

of questioning including: “Select all that apply,” Likert scale, and open ended questions. Each

were coded appropriately. We had several that required qualitative responses. In order to analyze

the qualitative data our research team read through all responses and highlighted recurring

themes which were then mentioned in our results.

Results

The findings from this evaluation were based off of the surveys administered to four

separate referral organizations, as well as post client surveys provided by Answers. Since the

data was collected from two separate sources, the following results offer two perspectives in

answering the evaluation questions.

The first evaluation question was: How can Answers improve outreach by engaging their

partners? Based off of the surveys collected the results suggest that partner organizations are

interested in engaging more frequently with Answers with the following informational focuses.

Several of the comments made in response to survey questions suggest that referral agencies are


satisfied with services, but improvements could be made to the working relationship between

their organization and Answers. Each responding agency reported that there is room to improve

their working referral partnership with Answers MSS. Two out of four of the agencies agreed

that a “good working referral partnership” was present, one agency responded neutrally, and one

responded strongly disagree. With the option “strongly agree” present, our findings suggest

space for improvement.

[GRAPH KEY: 1 = Strongly Agree; 2 = Agree; 3 = Neutral; 4 = Disagree; 5 = Strongly

Disagree]

The areas of outreach that could potentially use improvement in Answers’ relations to

referral organizations included: client referral materials (i.e. brochures, handouts, etc.) and a

“closer relationship” with referral organizations potentially through more face-to-face

communication. In response to the qualitative survey question, “how could Answers make it


easier to refer or provide services to meet your clients’ needs,” one organization responded that

meeting with their medical team would be beneficial.

The second evaluation question was: How can Answers improve outreach through

marketing? Based off of referral agency responses to what could improve outreach, marketing is

one of the main improvements suggested. Our findings suggest that several agencies only refer

clients based on very specific criteria. Three out of four agencies reported referring clients to

Answers based off of two or fewer referral criteria. Out of eight possible referral criteria, these

results suggest that agencies are not referring clients for services that Answers provides. The

graph below also depicts the consistencies in referral criteria. For example, the most common

referral criteria is general pregnancy, with three out of four agencies referring clients based on

this criteria. These findings suggest that Answers’ current outreach tactics are successful in

highlighting their general pregnancy services; at the same time, they suggest that some agencies

may not be informed about more specialized services.


Based off of the data collected from clients post service, our findings offer information

regarding outreach as well. WIC, medical services, and family planning were the top three

services utilized by respondents, with 100% of clients reporting referral and utilization. Such

high response rates suggest that these services are most commonly needed by clients and could

be areas to consider when looking to improve partner outreach. Services that were utilized least

often (in this case, never utilized by clients) included adoption, DVSAS, and the Job Service

Center (Employment Security). This could either suggest that clients do not commonly need

these services, or that outreach and referrals to these organizations could use more focus or

improvement.

Recommendations

Building on the interest of developing collaborative partnerships with Answers MSS,

several possible recommendations have been identified toward fulfilling this need. A step


toward this would include a monthly mandate on the staff of Answers MSS to visit the

collaborating organizations to report experiences with clientele, referrals, any gaps that need

addressing and goal setting. The meeting should consist of the one staff of Answers MSS, an

overseeing manager of the collaborating organization and a staff of that same organization that

works with referrals. In a world where faces are hidden behind computer screens and phone

calls, this meeting would provide an opportunity of direct interaction between organizations and

allow both parties to familiarize themselves more intimately with their collaborating partners.

The data suggested that organizations are interested in understanding the extent to which

referrals to Answers MSS are effective. These meetings can evaluate the success of support to

clientele and illustrate the effectiveness of Answers MSS. The purpose of these gatherings would

fold neatly into the interdisciplinary model of care previously mentioned in this paper. The

network of organizations would revolve around the care of the client and the stakeholders would

engage in best practices in order to meet the needs of women.

Given the need for a ‘closer relationship’ with their fellow organizations, we also

recommend that Answers MSS develop a marketing face. There is a need for visual presentation

when engaging partners for outreach. Visuals would help both Answers MSS in marketing itself,

as well as their partnering organizations when providing useful information in referrals to

clientele. A development of brochures regarding Answers’ services, contact information and

additional useful information, such as the overall experience of clients with Answer MSS

(statistical data), perhaps even a face for the client to recognize when coming into the office

could better clarify information to a client.

As a part of a marketing strategy, location is an important aspect to consider when

working with certain clientele. An independent office managed solely by Answers MSS would


create a safe space for women. Though there are many benefits to a conjoint space with DSHS

(as the Bellingham Answers MSS currently occupies) the environment and atmosphere may be

different than what Answers may want to project. A new location is a big consideration,

however, it will serve the clientele well with a safe and specific environment projected toward

the incoming clientele.

Along the lines of brochures and visuals, we recommend that Answers MSS continue

developing its existing website. The website contains immediate and easily identifiable contact

information, as well as several tabs regarding services, such as Crisis Family Intervention,

Community Resources, and Maternity Support Services (Answers: Counseling, Consultation and

Support Services, n.d.). These are great starting points to building an ‘About’ section regarding

information about Answers MSS, staff and founder(s). Expanding on eligibility would be

directly useful to clientele as well. Additionally, we recommend that the language of the website

be relatable to the clients that Answers serves and be personable (include words and phrases such

as ‘we’ and ‘our organization’). For example, the statement, ‘Services included are nursing,

nutrition, behavioral health…’ (Answers: Counseling, Consultation and Support Services, n.d.)

could be changed into a bulleted statement such as,

We at Answers MSS offer services that include:

nursing

nutrition

behavioral health

The website can then expand on each service for each bullet point if necessary. This changes the

website into a relaxed informational site for the benefit of the client. We also recommend neutral

colors for the appearance of the site to reinforce the feeling of a ‘safe space’ as well as bullet


points for quick information. The site should consider a welcoming presence of easily

understood information regarding the needs of all clients.

Limitations and Lessons Learned

Lack of Knowledge of Program

Several limitations on this particular evaluation process posed some challenges in

collecting, analyzing, and responding to data. One of the first limitations that our research team

came across was a lack of knowledge about the Answers MSS program when approaching

referral agencies. At this point in time, Answers’ primary marketing approach is through word of

mouth. Since specific individuals refer clients to Answers’ services, some staff at referral

agencies may be unfamiliar with Answers. With this information in mind our research team had

a difficult time connecting with specific individuals who knew about Answers’ services and their

referral frequency. Our research team would approach this limitation differently in the future by

contacting referral agencies earlier in the evaluation process. By approaching agencies earlier,

more time could be spent connecting with the appropriate individuals and agencies.

Small Sample

In evaluating the success of the referral partnerships that Answers holds with other

agencies within the Whatcom County community, an extensive sample that was representative of

all possible referral agencies would have been important. Due to time constrictions, a small list

of agencies Answers suggested we contact, and limited responses from the agencies we

contacted, the sample from which we gathered our data was detrimentally small. Because of this

limited sample, our findings cannot be considered generalizable to Whatcom County agencies as

a whole. From this experience the research team learned the importance of researching and

identifying a truly representative sample early in the evaluation process.


Context

Conducting the evaluation with a limited time scope for the process, our team did not

fully understand the context of Answers MSS and its collaborating partnerships. An extensive

knowledge of what each collaboration looked like and what the referral relationship was, would

have benefited our research and provided a clear framework for how to best approach the

evaluation. Each collaboration varies and the relationships vary along with them. A lack of that

context inhibited the research insofar as we did not understand the detailed working relationships

between Answers MSS and each of its referral organizations.

Time Limitations

Throughout the evaluation process we had a few time limitations that contributed to not

being able to get as much input and analysis as we would have liked. Our stakeholder Karla Cain

would have liked to have reach to more referring agencies in the area but as we only had four

weeks to complete the evaluation, we were only able to focus on a concise group. The restriction

of time continued as we had only a week to get in contact with other organizations to fill out the

surveys that were constructed, and get them returned in order to analyze. If we had more time we

would have been able to reach out to these partnering organizations as well as do more

informational interviews in order to add to our findings with the survey.


Appendix

Appendix A

Inadequate Prenatal Care County Map


Appendix B


Interdisciplinary/Interagency Model of Care

Appendix C


The following is a survey produced by a Western Washington University student evaluation team (from the Human Services Program). The survey will be used to evaluate the collaboration of Answers Maternity Support Services and its partnered agencies. Any identifying information

about the organization will remain confidential between the student evaluation team and the course professor. The results of the survey will help us determine how collaborative partnerships can progress in positive ways. By completing this survey you are consenting to the terms of the evaluation. You are under no obligation to complete this survey and you can refuse to answer

any questions and can stop the survey at any time.

1. Name of organization (will remain anonymous) _______________________________

1a. Your position/title within the organization: ________________________________

1b. Are you familiar with Answers Maternity Support Services?

__Yes __No

2. On average, I refer clients to Answers Maternity Support Services:

__ 0 times per month __ 1-3 times per month __ 4 -6 times per month

__7-9 times per month __ More than 10 times per month: ___

3. I refer clients seeking Maternity Support Services to Answers on the following criteria (select all that apply):

__ Low Income __ Substance Abuse

__ Mental Health __ General Pregnancy

__ Homelessness __ Nutritional Needs

__ Termination of pregnancy __ Other: __________________________________

4. I provide the following resources when referring clients to Answers Maternity Support Services (select all that apply):

__ Brochure(s) __ Business Card(s)

__ Handwritten information __ Website for Answers MSS

__ Other: ___________________

5. How could Answers make it easier to refer or provide services to meet your clients’ needs?


6. I feel that this organization has a good working referral partnership with Answers MSS

Strongly Agree Agree Neutral Disagree Strongly Disagree

7. In my experience, clients have been satisfied with the services provided to them by Answers Maternity Support Services.

Strongly Agree Agree Neutral Disagree Strongly Disagree

Appendix D


Each member of the research team contributed to specific aspects of the project. The tasks that

each member completed are outlined below:

Sierra acted as the research team “captain” as she gained and maintained regular contact

with the group’s stakeholder Karla Cain. Sierra also contributed to the evaluation plan

and report with her own background knowledge and with an in-depth review of the

existing literature on the community need. When deciding on the data collection strategy,

Sierra helped in writing the survey, as well as contacting organizations to complete the

survey, and finally coding and analyzing data from the surveys. Sierra’s role as captain

continued as she did the final edit of the evaluation report and structured the paper to

meet APA standards to be turned in. As a participating team member, Sierra was engaged

in all group activities.

Emily kept an open communication line throughout the process of the evaluation report.

Recorded and helped code the qualitative data that was found in the surveys from

Answers, as well as created a “findings” document filed with the data we collected from

those qualitative sections. When creating the evaluation report, she was in charge of the

“Evaluation Activities” section. We all pursued referral organizations, including two of

which Emily was able to collect surveys from. Finally, Emily also contributed to the

overall editing of the final report along with the entire research team as well as the

development of the visual presentation with her co-researchers.

Zarina contributed a diverse role of assistance to the research team. This role included

final peer review for the Evaluation Plan, developing the survey used for the evaluation,

contacting organizations to distribute the survey and assisting with analysis. Pulling

directly from the results of the data, Zarina also provided a list of recommendations that


were suitable to meet both the Evaluation Questions and the needs of Answers MSS.

Working alongside the rest of the research members, Zarina also provided general

revision work.

Ashley’s role in the evaluation team included: timeline preparation, evaluation proposal

program description, survey distribution, survey results analysis, and editing of the final

report along with the entire research team. The group collaborated to create outlines for

both the proposal and the report, also providing feedback to team members throughout

the process over the medium, Google Documents. Face-to-face collaboration was

significant in order to create a more cohesive and accurate evaluation report. Each team

member was held to these standards.

References


Answers: Counseling, Consultation & Case Management Services. (n.d.). Answers: counseling,

consultation & support services. Retrieved from

http://www.answerscounseling.org/mss.htm

Farrow, D., Baldwin, L., Cawthon, M., & Connell, F. (1996). The impact of extended maternity

services on prenatal care use among Medicaid women. American Journal Of Preventive

Medicine, 12(2), 103-107.

Maternity Support Services Infant Case Management Resource Guide (2012). Retrieved from

http://www.hca.wa.gov/medicaid/firststeps/documents/p_mss_ic_cbe_resourceguide.pdf

National Center for Health Statistics, final natality data (2014). Inadequate prenatal care:

Washington, 2001-2011. Retrieved from

http://www.marchofdimes.com/Peristats/ViewSubtopic.aspx

National Center for Health Statistics, final natality data (2014). Infant mortality rates: United

States, 1975-2000. Retrieved from

http://www.marchofdimes.com/peristats/ViewSubtopic.aspx

Norwood, S. (1994). First steps: Participants and outcomes of a maternity support services

program. Journal Of Obstetric, Gynecologic, And Neonatal Nursing: JOGNN /

NAACOG, 23(6), 467-474.