270375 Fidelity, outcomes, and peer provider evaluation in a state ACT program

Tuesday, October 30, 2012 : 9:30 AM - 9:50 AM

Gregory B. Teague, PhD , Mental Health Law and Policy / FMHI /CBCS, University of South Florida, Tampa, FL
Assertive Community Treatment (ACT) is a comprehensive service program for people with serious mental illnesses that has a significant evidence base for effectiveness in reducing hospital use and improving community tenure. The model has evolved since its inception over thirty years ago to incorporate treatments as they are demonstrated to be effective in achieving outcomes for this population in other domains such as employment and substance abuse. However, the research record is more equivocal regarding ACT's effectiveness in these more recovery-oriented domains, but data on the degree of implementation of these practices within ACT teams studied has been scant. A recent fidelity measure, the Tool for Measurement of ACT, has been developed to address this gap and more generally to assess the salience of recovery-oriented practices within teams and serve as a reference to support quality improvement. At the same time, assessing fidelity for such a comprehensive program is a labor-intensive process for which adequate external resources cannot always be identified. One state has undertaken to approach this process on a peer-consultation basis, developing a capacity for mutual support among teams. This presentation will provide a brief overview of the TMACT and recent supplemental components to improve its use in quality-improvement; identify key issues in implementing a peer-evaluation and –consultation model with multiple teams in a large state; and report on fidelity using the TMACT, outcomes using administrative data, and the relationships between fidelity and outcomes in this setting.

Learning Areas:
Administration, management, leadership
Chronic disease management and prevention
Conduct evaluation related to programs, research, and other areas of practice
Other professions or practice related to public health
Provision of health care to the public

Learning Objectives:
Describe selected key features of an enhanced fidelity measure for assertive community treatment; Discuss key challenges and possible approaches to developing alternative approaches to program assessment and quality improvement; Identify issues in examining the relationship of program characteristic and outcomes.

Keywords: Mental Illness, Evidence Based Practice

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been the principal or co-investigator of federal and state funded studies of assertive community treatment and have been the developer of fidelity measures for this program model that are in widespread use internationally.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.