The Center for Mental Health Services (CMHS) and Center for Substance Abuse Treatment (CSAT) co-sponsored a four-year program that documented and evaluated strategies to prevent homelessness in individuals with psychiatric and/or substance use disorders. All eight sites used a common interview protocol and measures but reflected substantial diversity in interventions and populations. This cross-site variance ruled out conventional multi-site analytic approaches involving pooling of data. Instead, a multiple, meta-analytic approach was adopted that entailed including relevant subsets of sites for examination of outcomes in relation to specific experimental contrasts. This approach in turn required uniform assessment of interventions across all sites in terms of characteristics reflecting the cross-site pool of study hypotheses. This assessment allowed empirical determination of which sites would be included in each analysis.In collaboration with investigators in all sites, the authors developed a rating instrument specifically for this multi-site study, extrapolating and adapting content and methods from the Dartmouth Assertive Community Treatment Scale, a program fidelity measure. Fourteen hypothetical experimental contrasts were identified in three clusters: housing models, overall services models, and other treatment/service foci. Actual ratings allowed merging and reduction of contrasts to a feasible number for evaluation using data from the eight sites. The presenter will discuss the rationale for this assessment process, the development of the cross-site assessment tool, assessment results, and application of this method in obtaining findings in the cross-site study.
Learning Objectives: Define and describe the purpose of fidelity measures in multiple site research projects. Articulate the process used in the Homelessness Prevention Project to determine appropriate experimental contrasts for cross-site analytic purposes. Identify some program characteristics that were used to answer specific research questions on preventing and reducing homelessness for individuals with serious mental illness and/ or substance abuse disorders
Keywords: Homelessness, Evaluation
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.