Organizational network analysis as a tool for program evaluation.

Health program evaluation is generally focused on an examination of individual program characteristics and accomplishments, yet many programs are part of a broader service system. Evaluation of the role a program plays in that system is an important evaluation question to address. A network analysis of program referral patterns was used to evaluate Connecticut's Healthy Start program. Network analysis showed that Healthy Start played a "broker" role in 4 case study communities, sending and receiving referrals of pregnant women to a higher than average number of other programs. Further, in the urban area case study, competing market players providing services to pregnant women resulted in subsets of services with dense referral patterns within the subsets, but little referral between subsets. Healthy Start was found to be instrumental as an integrator of these otherwise disconnected service subsets.