Kim S, Wurster L, Williams C, Hepler N
DataBase Evaluation Research, Inc., Tampa, Florida, USA.
J Drug Educ. 1998;28(4):283-306. doi: 10.2190/K481-P34V-L8VR-GBQJ.
The purpose of Part 3 is to develop an algorithm for an equitable distribution of state prevention funds to its substate jurisdictions based on the need for prevention services. In this series, the need for prevention services is measured in terms of the existing social indicators observed at the county level. In order to establish a conceptual link as well as the empirical relevance of the selected social indicators as proxy measurements of the estimated need for prevention at the county level, we have employed both concurrent and construct validity tests using the following three constructs as the criterion variables in a multiple regressing setting: 1) county-based composite drug use index score (COMDRUG) measured via the statewide drug survey; 2) county-based proportions of prevention target populations using the conceptual definition advanced by the Institute of Medicine (IOM); and 3) the composite risk factor score (COMRISK) assembled from a list of twenty-two risk and protective factors observed for each county. These constructs were identified previously in Parts 1 and 2. While employing eight social indicators to estimate the overall prevention needs observed at the county level, the social indicators thus selected were able to explain 69 percent of the variations in COMDRUG, 68 percent of the variation in the proportions of students in need of prevention services using IOM definition, and 60 percent of the variation in COMRISK. Following successful validations of the social indicators as viable media with which to estimate county-based prevention needs, the ensuing multiple regression equation is, then, used to build a resource allocation model by determining the proportion of each county's share of the total statewide COMDRUG-predicted from the social indicators and, then, by weighting the latter proportion by the population size of each county under age eighteen. In this way, we have devised county-based Prevention Needs Index (PNI) scores based solely on social indicators. Finally, the county's share of PNI score is computed as a proportion of to the total statewide PNI score. Following this line of algorithm for resource allocation, we were able to develop yet another resource allocation model solely based on social indicators without the benefits of survey data. Comparing the funding results originating from four resource allocation models (i.e., COMDRUG, IOM Definition, COMRISK, and Social Indicators), it has been learned that there is a remarkable similarity from one funding level to another. Since all four schedules of county-based prevention funding levels have shown very high intercorrelations with a range from .9862 to .9993, it has been determined that these schedules are measuring essentially either the same domain or latent domains that are functionally equivalent to one another. Accordingly, no preference is made among the resource allocation models suggested, although it is suggested that the final decision on the level of funding must be based on the selection of the schedule for resource allocation rather than the suggested amount or level of funding computed for each county.
第三部分的目的是开发一种算法,以便根据预防服务的需求,将州预防资金公平分配到其下属司法管辖区。在本系列中,预防服务的需求是根据在县一级观察到的现有社会指标来衡量的。为了建立概念联系,并验证所选社会指标作为县一级预防需求估计值的代理测量指标的实证相关性,我们在多元回归设置中,使用以下三个构建作为标准变量,进行了同时效度和结构效度测试:1)通过全州药物调查测量的基于县的综合药物使用指数得分(COMDRUG);2)使用医学研究所(IOM)提出的概念定义,基于县的预防目标人群比例;3)从为每个县观察到的二十二个风险和保护因素列表中汇总得出的综合风险因素得分(COMRISK)。这些构建在第一部分和第二部分中已预先确定。在使用八个社会指标来估计县一级观察到的总体预防需求时,所选择的社会指标能够解释COMDRUG中69%的变异、使用IOM定义的需要预防服务的学生比例中68%的变异,以及COMRISK中60%的变异。在成功验证这些社会指标作为估计县一级预防需求的可行媒介之后,接下来的多元回归方程被用于构建资源分配模型,方法是确定根据社会指标预测的全州COMDRUG总额中每个县的份额比例,然后通过每个县18岁以下人口规模对后一比例进行加权。通过这种方式,我们仅基于社会指标设计了基于县的预防需求指数(PNI)得分。最后,县的PNI得分份额是作为其占全州PNI总得分的比例来计算的。按照这条资源分配算法,我们能够仅基于社会指标开发另一种资源分配模型,而无需调查数据的支持。比较来自四种资源分配模型(即COMDRUG、IOM定义、COMRISK和社会指标)的资金分配结果,我们发现从一个资金水平到另一个资金水平存在显著的相似性。由于所有四种基于县的预防资金水平时间表都显示出非常高的相互关联性,范围从0.9862到0.9993,因此可以确定这些时间表基本上测量的是相同的领域或功能上彼此等效的潜在领域。因此,在所建议的资源分配模型中不做偏好选择,不过建议关于资金水平的最终决定必须基于资源分配时间表的选择,而不是为每个县计算的建议资金数额或水平。