title: When performance management works: a study of the National Breast and Cervical Cancer Early Detection Program.
abstract: BACKGROUND
  Little empirical evidence exists about the effectiveness of performance management systems in government. This study assessed the effectiveness of the performance management system of the National Breast and Cervical Cancer Early Detection Program (NBCCEDP) and explored why it works.
  
  
  METHODS
  Generalized estimating equation models were used to assess change in program performance after the implementation of a performance management system. In addition, qualitative case study data including observations, interviews, and document review were analyzed using inductive methods.
  
  
  RESULTS
  Five of the 7 indicators tested had statistically significant increases in performance postimplementation. Case study results suggest that the system is characterized by high-quality data, measures viewed by grantees as meaningful and fair, and institutionalized data use.
  
  
  CONCLUSIONS
  Several factors help to explain the system's effectiveness including characteristics of the NBCCEDP program (eg, service delivery program), qualities of the indicators (eg, process level), financial investment in the system, and a culture of data use.
authors.affiliation: Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Amy
authors.initials: A
authors.lastname: DeGroff
authors.forename: Janet E
authors.initials: JE
authors.lastname: Royalty
authors.forename: Will
authors.initials: W
authors.lastname: Howe
authors.forename: Dennis W
authors.initials: DW
authors.lastname: Buckman
authors.forename: James
authors.initials: J
authors.lastname: Gardner
authors.forename: Theodore
authors.initials: T
authors.lastname: Poister
authors.forename: Nikki
authors.initials: N
authors.lastname: Hayes
mesh_terms: D001943:Breast Neoplasms / Q000175:diagnosis*; D055088:Early Detection of Cancer / Q000379:methods* / Q000592:standards; D005260:Female; D006801:Humans; D008403:Mass Screening / Q000379:methods / Q000458:organization & administration* / Q000592:standards; D019984:Quality Indicators, Health Care; D014481:United States; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis*
keywords: early detection of cancer; government programs; program evaluation; public health
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