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Funded by the Robert Wood Johnson Foundation and The Atlantic Philanthropies, Better Jobs Better Care (BJBC) was a demonstration program that sought to bring about changes in public policy and management practice that would lead to improved recruitment and retention of high-quality paraprofessional direct care workers (DCW) in nursing homes as well as in home- and community-based settings. This was to be accomplished by implementing both policy and management practice goals. Policy goals included developing initiatives related to wages and benefits, incentives for job redesign, curriculum and credentialing, professional associations, and promotion of public awareness and policies. Practice goals involved interventions related to caregiving skill development, peer mentoring, team building, top management training, supervisor training, and provider-specific interventions. The program established demonstration projects in Iowa, North Carolina, Oregon, Pennsylvania, and Vermont which enrolled long-term care establishments across the spectrum of long-term care settings: skilled nursing facilities, assisted living facilities, home care agencies, and adult day service providers.

Conducted as part of the BJBC evaluation, which used a before-after design to assess the implementation of the interventions and their impact, this survey of the top clinical manager at each participating long-term care provider explored the establishments' organizational characteristics and management practices. One version of the survey was administered at the beginning of the demonstration (Time1), and a second version, toward the end of the demonstration (Time 2). Organizational characteristics covered by the survey include nonprofit/for-profit status, whether the establishment was free standing or part of a chain, number of competing establishments, whether the DCWs were unionized, and the type and amount of services provided. Management practices investigated by the survey include participation in care planning, communication about tasks, feedback, DCW training, management communication, organizational readiness for change, professional development, and work design practices. The survey also collected information about the racial and Hispanic origin composition of DCWs and patients/residents/clients.

Funded by the Robert Wood Johnson Foundation and The Atlantic Philanthropies, Better Jobs Better Care (BJBC) was a demonstration program that sought to bring about changes in public policy and management practice that would lead to improved recruitment and retention of high-quality paraprofessional direct care workers (DCW) in nursing homes as well as in home- and community-based settings. This was to be accomplished by implementing both policy and management practice goals. Policy goals included developing initiatives related to wages and benefits, incentives for job redesign, curriculum and credentialing, professional associations, and promotion of public awareness and policies. Practice goals involved interventions related to caregiving skill development, peer mentoring, team building, top management training, supervisor training, and provider-specific interventions. The program established demonstration projects in Iowa, North Carolina, Oregon, Pennsylvania, and Vermont which enrolled long-term care establishments across the spectrum of long-term care settings: skilled nursing facilities, assisted living facilities, home care agencies, and adult day service providers.

Conducted as part of the BJBC evaluation, this survey interviewed DCWs at two points during the demonstration. The Time 1 interview was fielded as soon as establishments enrolled in the demonstration and provided a list of their DCWs (July 2004 to December 2006), and the Time 2 interviews were completed 12 to 28 months after the Time 1 interviews (April 2006 to June 2007). Both rounds of the survey used the same self-administered questionnaire which included questions about length of employment, job satisfaction, job rewards and problems, supervision, perceptions of quality of care, job confidence, training, intent to quit, and demographic characteristics. The survey also elicited recommendations for improving DCWs' jobs by asking the open-ended question "What is the single most important thing your employer could do to improve your job as a direct care worker?"

In long-term care, frontline supervisors play a central role in direct care workers' (DCW) job quality and turnover and are critical to the implementation of management changes. To better understand supervisors' perceptions of management practices, the quality of supervision, and the effect on DCW turnover and job quality, the Office of the Assistant Secretary for Planning and Evaluation in the United States Department of Health and Human Services contracted with Pennsylvania State University to conduct this survey of supervisors participating in the Better Jobs, Better Care (BJBC) demonstration. Funded by the Robert Wood Johnson Foundation and The Atlantic Philanthropies, the BJBC demonstration -- which took place in Iowa, North Carolina, Oregon, Pennsylvania, and Vermont -- tested innovative policy and practice models designed to improve the quality of DCW jobs in an effort to improve recruitment and retention of these workers and strengthen capacity to meet future demand for long-term care.

Frontline supervisors were interviewed from the four types of facilities and agencies that participated in the demonstration: skilled nursing facilities, assisted living facilities, home care agencies, and adult day service providers. The survey explored the supervisors' job responsibilities, formal training, job satisfaction, and thoughts about quitting. It investigated the culture of the organizations in which the supervisors worked, probed for problems with the supervisors' jobs, assessed how rewarding the supervisors felt their jobs were, inquired as to whether the supervisors felt respected by their clients, DCWs, and managers, gauged the supervisors' assessments of the overall competency level of the DCWs in their organizations, and explored the supervisors' beliefs about managerial support for the BJBC project, how well the BJBC programs were executed, and whether the overall impact of the project was positive.

In addition, the respondents were queried about management practices (e.g., rotation of assignments to different services or units, mechanisms to handle employee concerns, and approaches used to handle poor performance or negative behaviors among employees). They were also asked about DCW training, mentoring, and career ladder programs, DCW participation in patient/resident/client care plans, and communication among DCWs and between DCWs and their supervisors. Respondents were also asked what was the most important thing that their employer could do both to improve the jobs of DCWs and to improve their own ability to do their jobs as supervisors of DCWs. Additional information collected by the survey includes the supervisors' age, sex, race, Hispanic origin, educational attainment, nursing degree or license (LPN, RN, Diploma RN, BSN, MSN, or Advanced Practice Nurse), wages, and health insurance coverage.

This collection comprises three data files: (1) Supervisor Identification Instrument Data, (2) Supervisor Survey Data, and (3) Clinical Managers Who Are Also Supervisors Data. The first file contains information collected by the Supervisor Identification Instrument that was submitted to the clinical manager at each BJBC provider organization. This instrument instructed clinical managers to name all of the supervisors in their organization and to indicate which supervisory responsibilities each one performed. The second data file contains the responses to the Supervisor Survey questionnaire.The third data file contains the responses of clinical managers who also functioned as supervisors in their organization. These clinical managers responded to the same questions in the Supervisor Survey questionnaire, except for ten questions that were worded somewhat differently.

The Helping Young Smokers Quit (HYSQ) initiative was a multi-phase project that addressed the critical need to disseminate effective, developmentally appropriate cessation programs for young smokers. Phase I identified and described tobacco treatment programs available for youth in the United States, Phase II evaluated smoking secession programs tailored for youth to help understand what works, and Phase III identified factors associated with program sustainability. Phase II collected data from five sources: (1) program participants, (2) program providers, (3) program curricula, (4) organizational leaders, and (5) community leaders and community ordinances.

Program participants were interviewed at baseline, end-of program, 6-month follow-up, and 12-month follow-up. Topics covered by the interviews include age, gender, race, Hispanic origin, language spoken at home, employment, income, religiosity, school enrollment, education level, school grades, height, weight, extracurricular activities, recreation, sports, exercise, aspirations after high school, psychological well-being, alcohol consumption, cigarette use and use of other tobacco products, attitudes about smoking, plans to stop/continue smoking, attempts to quit smoking, reasons for participating in the program, topics/issues covered by the program, opinions about the program, and smoking experience since the beginning of the program. In addition, for each follow-up survey, the participants provided a breath sample for carbon monoxide analysis to validate self-reported quit status.

After the last session of each program delivery, the program providers, such as program leaders and cessation counselors, were interviewed about the content and delivery of the program and the reactions of the participants and themselves to the program as delivered. The program providers also kept attendance records.

Curriculum content was abstracted from program manuals and other materials used in each program.

Organizational leaders of the organizations that offered the programs were surveyed about various aspects of each organization, including the organization's smoking cessation program and the organization's mission, general operations, and smoking-related policies and practices.

Community-level information was collected in two ways: (1) interviews of community leaders representing local health departments, school boards, and juvenile justice offices, and (2) archival research of public ordinances relevant to tobacco and control policies.

Nine data files/datasets constitute the data. Datasets 1-4 contain the participant questionnaire data, carbon monoxide measurement data, and program attendance data. Dataset 5 comprises information about each program and its curriculum, some information about the community in which the program was located, and summary data about enforcement of tobacco-related ordinances. Dataset 6 contains information about about the program providers and each program delivery, including recruitment, logistics, content, and the reactions of providers and participants. Dataset 7 covers administrative aspects of the smoking cessation programs and each offering organization's mission, general operations, and smoking-related policies and norms. Dataset 8 contains information about local and state-level tobacco-related ordinances for every state and local jurisdiction where each program was located, and Dataset 9 condenses the information in Dataset 8 into one summary record for each community. The unit of observation for Datasets 1-4 is the participant, for Datasets 5 and 7 the smoking cessation program/offering organization, for Dataset 6 the program delivery/program cohort, for Dataset 8 the ordinance, and for Dataset 9 the community.

In 2008, a group of uninsured low-income adults in Oregon was selected by lottery to be given the chance to apply for Medicaid. This lottery provides an opportunity to gauge the effects of expanding access to public health insurance on the health care use, financial strain, and health of low-income adults using a randomized controlled design. The Oregon Health Insurance Experiment follows and compares those selected in the lottery (treatment group) with those not selected (control group). The data collected and provided here include data from in-person interviews, three mail surveys, emergency department records, and administrative records on Medicaid enrollment, the initial lottery sign-up list, welfare benefits, and mortality.

This data collection has seven data files:

Dataset 1 contains administrative data on the lottery from the state of Oregon. These data include demographic characteristics that were recorded when individuals signed up for the lottery, date of lottery draw, and information on who was selected for the lottery, applied for the lotteried Medicaid plan if selected, and whose application for the lotteried plan was approved. Also included are Oregon mortality data for 2008 and 2009.

Dataset 2 contains information from the state of Oregon on the individuals' participation in Medicaid, Supplemental Nutrition Assistance Program (SNAP), and Temporary Assistance to Needy Families (TANF).

Datasets 3-5 contain the data from the initial, six month, and 12 month mail surveys, respectively. Topics covered by the surveys include demographic characteristics; health insurance, access to health care and health care utilization; health care needs, experiences, and costs; overall health status and changes in health; and depression and medical conditions and use of medications to treat them.

Dataset 6 contains an analysis subset of the variables from the in-person interviews. Topics covered by the survey questionnaire include overall health, health insurance coverage, health care access, health care utilization, conditions and treatments, health behaviors, medical and dental costs, and demographic characteristics. The interviewers also obtained blood pressure and anthropometric measurements and collected dried blood spots to measure levels of cholesterol, glycated hemoglobin and C-reactive protein.

Dataset 7 contains an analysis subset of the variables the study obtained for all emergency department (ED) visits to twelve hospitals in the Portland area during 2007-2009. These variables capture total hospital costs, ED costs, and the number of ED visits categorized by time of the visit (daytime weekday or nighttime and weekends), necessity of the visit (emergent, ED care needed, non-preventable; emergent, ED care needed, preventable; emergent, primary care treatable), ambulatory case sensitive status, whether or not the patient was hospitalized, and the reason for the visit (e.g., injury, abdominal pain, chest pain, headache, and mental disorders).

The collection also includes a ZIP archive (Dataset 8) with Stata programs that replicate analyses reported in three articles by the principal investigators and others:

Finkelstein, Amy et al "The Oregon Health Insurance Experiment: Evidence from the First Year". The Quarterly Journal of Economics. August 2012. Vol 127(3).

Baicker, Katherine et al "The Oregon Experiment - Effects of Medicaid on Clinical Outcomes". New England Journal of Medicine. 2 May 2013. Vol 368(18).

Taubman, Sarah et al "Medicaid Increases Emergency Department Use: Evidence from Oregon's Health Insurance Experiment". Science. 2 Jan 2014.

Coverage expansion under the Affordable Care Act (ACA) has important implications for access, and the value of coverage is dependent on the ability to access care. Most information about access to care comes from household or physician surveys.

The current data collection was gathered as a part of the Primary Care Audit Study for 10 States in the United States, 2012-2013, 2014 and 2016 to assess variation in access to primary care using a methodology that was applied across different types of states (Arkansas, Georgia, Illinois, Iowa, Massachusetts, Montana, New Jersey, Oregon, Pennsylvania, and Texas) at baseline and over-time. The project was broken up into three phases: before the ACA (2012-2013), during the launch of ACA coverage provisions such as the Medicaid fee bump and ACA marketplaces (2014), and after the full ACA implementation (2016). Insurance types in the study included commercial coverage, Medicaid, uninsured, and, in 2014 and 2016, plans purchased on the ACA market place.

The audit-level file, featured in part one of the collection, includes all completed calls and provides information from multiple dimensions (appointment availability, wait times, simulated patients' demographics, cost information, etc.).

The office-level file, featured in part two of the collection, covers all eligible offices and their characteristics (e.g., size, insurance acceptability, cost information, etc.) collected from the screening phase.

Demographic variables include simulated caller number, race, gender, and age.