Heather Smith Fowler

Special Issue

Conducting evaluation research with hard-to-follow populations: adopting a participant-centred approach to maximize participant retention

Authors:
Pages:
89-108

Longitudinal designs are effective for the evaluation of innovative social programs, but attrition can be a significant problem, particularly with hard-to-follow populations such as persons who are homeless. Tracking strategies for locating participants are essential, but retaining participants requires anticipating and addressing participants' needs at every stage of the research. A strategy that emphasizes appropriate interviewer characteristics, the relationship between interviewer and participant, and participants' "investment" in the research is critical. In other words, evaluation researchers can improve the retention of even hard-to-follow study participants by adapting research design and procedures to be "participant-centred." An example is given of a program evaluation in Ottawa, Ontario, that implemented strategies to adapt to the needs of persons with severe mental illness and a history of homelessness.

Inside the black box: challenges in implementation evaluation of community mental health case management programs

Authors:
Pages:
109-133

Fidelity measurement is an evolving field in mental health case management program evaluation. This article presents an exploratory study in which two separate fidelity measures, the Dartmouth Assertive Community Treatment Scale (DACTS) and the Key Component Profiles (KCP), were used to assess structure and process elements of three mental health case management programs. The programs were studied because they all provided services to seriously mentally ill inner city populations and shared a common context for practice. However, one program followed the Assertive Community Treatment (ACT) model, the other two were Intensive Case Management (ICM) programs, and one of the ICM programs formed a significant partnership with a home care agency for service delivery. The extent to which the DACTS and KCP were able to measure the structure and process similarities and differences of the programs is examined. The results provide information for evaluators on the possible strengths and limitations of each fidelity tool in differentiating various elements of the case management models and reinforce the importance of assessing program fidelity from a multi-dimensional perspective.