| Main Purpose |
The purpose of this module is to record characteristics of
clients who are admitted to services. |
| Description |
- The form collects major demographics and background characteristics of the individual
who receives services.
- This module can be a fax-in form or a download from a database.
|
| Target Projects for Form |
- All projects that see clients as service users (not training projects that assess client
outcomes as a function of training).
- This evaluation tool would be maximally useful if all projects code this information
from all clients.
|
| Major Evaluation Function |
- The module characterizes clients seen in the services.
- Enrollment date is recorded.
- Major background characteristics are used for comparisons of program experience and
effects.
|
| Implementation |
- Module 1 Current Version (dated 1/15/95) Activation Number: 37240.
- Module 1 (Spanish) Current Version (dated 8/1/97) Activation Number: 1837.
- Module 1S (Self-Administered) Current Version (dated 11/1/95) Activation Number: 62199.
- Module 1S (Self-Administered for NY State AIDS Institute Site) Current Version (dated
2/26/96) Activation Number: 31749.
|
| Citation(s) |
- Huba, G. J., Melchior, L. A., Staff of The Measurement Group, and
HRSA/HAB's SPNS Cooperative Agreement Steering Committee (1997). Module 1: Demographic-Contact Form.
Available: www.TheMeasurementGroup.com. Culver City,
California: The Measurement Group.
|
