Ladel Lewis, Ph.D.
Carolyn Sullins, Ph.D.
The Kercher Center for Social Research
Western Michigan University




Comprehensive Community Mental Health
Services for Children and Their Families
Program: “Systems of care.”
incorpora...




144 sites have been or are in the process of
being evaluated. Each 1-2 year cohort: +/- 30
sites.
Each SoC has disti...





Child centered and
family driven
Community based
Culturally
competent










Presenting issues of the youth
Youth’s level of functioning (strengths and
weaknesses)
Family strengths a...








“One size fits all” battery
of questions
HSIRB mandates re
language on consent
forms
Ensuring an adequate
samp...


History of racist abuse by researchers (E.g., Tuskegee
syphilis study)





Misinterpretation of data, or no access ...
Insurance

n=244

Private Ins
Public Ins
9%

90%

Caucasian:

Ages 7-17
Diagnosed
with a
Severe
Emotional
Disturbance

49....






Informed consent
Voluntary
participation
Confidentiality
and its exceptions
Parents, various social service workers, eval staff
 Reviewed consent forms for clarity
 Gave opinions to HSIRB re child...






We came to their group
Help re local language
Helped us make it more
comfortable for
participants
Info that late...
Does confidentiality mean…
 No interviews in public
places, even if that’s what
participants request?
 Kicking Grandma o...



Some found it emotionally draining
Too long and redundant





Questionnaires with overlapping questions

Categori...


“Evaluating System of Care
– not you”




Non-judgmental attitude for
better rapport, retention,
AND accuracy.




...






Offer breaks, gum,
stress balls, etc. to
participants
Coloring books, DVDs
for young kids
Redundant questions
fro...










Family address tracking
form
Birthday and holiday cards
with coupons
Incentives for families to
contact us
...
African Americans

00

Caucasians

19.1%

00
Participants

Partcipants

22.8%
77.2%

NonParticipants

Chi Square (1, N=224...
African American

Caucasian

00

00

Participants
27.9%

Participants
22.1%

72.10

NonParticipants

77.9%

Chi Square= (1...
African American

Caucasian

00

00
Participants

36.8%

Participants
30.6%

63.2%

NonParticipants

Chi Square= (1, N=119...
African American

Caucasian

00

00

Participants
40.4%

Participants
43.2%

59.6%

NonParticipants

Chi Square= (1, N=91)...
African American

Caucasian

00

00

Participants
37.9%

47.8%
52.2%

Participants

NonParticipants

62.1%

Chi Square= (1...




Fulfilling national
evaluation
requirements within a
local context is a
constant balancing act.
With enough input
fr...







Please contact
carolyn.sullins@wmich.edu
Or Ladel_lewis@yahoo.com
For more info, please see also
http://www.wmi...
Consistent Protocol, Unique Sites: Seeking Cultural Competence in a Multisite Evaluation
Upcoming SlideShare
Loading in...5
×

Consistent Protocol, Unique Sites: Seeking Cultural Competence in a Multisite Evaluation

189

Published on

Washington Evaluators Brown Bag
by Ladel Lewis
August 28, 2012

Evaluating one site of a federally funded, longitudinal, multi-site initiative to improve services for children with mental health issues and their families presents numerous challenges. Many individuals, particularly racial minorities, are understandably reluctant to participate or remain in an evaluation concerning such sensitive issues. Further, not all the sites fit neatly into the same “one size fits all” evaluation protocol that must be used at all the sites. Cultural competence is crucial regarding: (1) breaking the barriers to participation; (2) balancing the traditional perspectives of “informed consent” and “confidentiality” with those of the participants; (3) balancing the need for consistent measures in our national study with the local realities of our participants; (4) interpreting and reporting the results. Seeking input from stakeholders at each step of the evaluation helped us recognize and overcome these barriers, and attain equitable recruitment and retention rates among Caucasian and African-American participants.

Ladel Lewis received a B.A. in Criminal Justice from the University of Michigan in 2001 and a M.A. in Sociology in 2005 from Western Michigan University. Studying evaluation research under Dr. Chris Coryn at the Evaluation Center, she earned her Ph.D. in Sociology in 2012 at Western Michigan University. She has published journal articles across disciplines such as “User Perceptions of Accessible GPS as a Wayfinding Tool for Travelers with Visual Impairments” published in the AER Journal: Research and Practice in Visual Impairment and Blindness, “White Thugs & Black Bodies: A Comparison of the portrayal of African American Women in Hip-Hop Videos” published in the Hilltop Journal and “Lights, Camera Action: The Portrayal of African American Women In Hip Hop Videos” in the Call & Response Journal.

Published in: Education, Health & Medicine
0 Comments
0 Likes
Statistics
Notes
  • Be the first to comment

  • Be the first to like this

No Downloads
Views
Total Views
189
On Slideshare
0
From Embeds
0
Number of Embeds
4
Actions
Shares
0
Downloads
0
Comments
0
Likes
0
Embeds 0
No embeds

No notes for slide
  • All sites focused on these 3 things!!-Treatment is supoosed to be based on whats based on the child, and supported by their family, not whats easiest for the clinician.-Many used wrap around services that utilized community efforts to assist the consumer. Pastor, social worker, probation worker and parents were involved in the youths service plan.-Examples of cultural competence are being sensitive too religious beliefs (e.g. no services on specific days/times ), taking off shoes when they enter certain areas of the house and so forth
  • Questionnaires are not modified for the specific consumers. All consumers have the same instruments regardless of the consumers diagnosis. ADD consumers have to answer the same questions as ODD consumers.Consent forms are written in legalese making it hard for respondents to unerstandYou must have consumer and clinician buy in. How many is good enough? 30 or 300 people?Because of the transient population, we must apply special techniques to keep up with them and encourage them to want to stay in the study.
  • We initiated several methods to ensure our evauation team were in compliance with professional guidelines, yet, in tune with the needs of the community.-We get all types of feedback. For example….we wanted feedback about communications. What will be the best mehod to contact respondents. Next, should we hand write the addresses or use labels. Show envelopes.
  • We came to youth, rather than expecting them to come to our boring evaluation meetings.We learned new names for drugs and so forth
  • -we constatly asked them to reflct back 6 months to a year ago--interviewers didn’t know what terms mean so we could not convey it to the repondents, thus leading to response bias
  • Consistent Protocol, Unique Sites: Seeking Cultural Competence in a Multisite Evaluation

    1. 1. Ladel Lewis, Ph.D. Carolyn Sullins, Ph.D. The Kercher Center for Social Research Western Michigan University
    2. 2.   Comprehensive Community Mental Health Services for Children and Their Families Program: “Systems of care.” incorporates a broad, flexible array of effective services and supports for a defined, multi-system population that is organized into a coordinated network… is culturally and linguistically competent, builds meaningful partnerships with families and youth at service delivery, management and policy levels, and has supportive policy and management infrastructure. (Pires, Lazear, & Conlan, 2008).
    3. 3.   144 sites have been or are in the process of being evaluated. Each 1-2 year cohort: +/- 30 sites. Each SoC has distinct:     geographic location and scope (e.g., statewide, county wide, city-wide, tribal) Ages of the youth served Mental health issues facing the targeted youth Racial, ethnic, and cultural factors
    4. 4.    Child centered and family driven Community based Culturally competent
    5. 5.        Presenting issues of the youth Youth’s level of functioning (strengths and weaknesses) Family strengths and barriers Types of services family and youth are receiving Satisfaction with services Cultural competence of services Youth and family input into services
    6. 6.     “One size fits all” battery of questions HSIRB mandates re language on consent forms Ensuring an adequate sample size Ensuring retention in a mobile population
    7. 7.  History of racist abuse by researchers (E.g., Tuskegee syphilis study)    Misinterpretation of data, or no access to results Sensitive or stigmatized topics even more difficult Families overwhelmed or embarrassed
    8. 8. Insurance n=244 Private Ins Public Ins 9% 90% Caucasian: Ages 7-17 Diagnosed with a Severe Emotional Disturbance 49.1% (including White Latino/a: < 5%) African-American/Multiracial: 50.9%
    9. 9.    Informed consent Voluntary participation Confidentiality and its exceptions
    10. 10. Parents, various social service workers, eval staff  Reviewed consent forms for clarity  Gave opinions to HSIRB re child abuse reporting  Parent input re: communication among clinicians, families, and interviewers  Interpretation of data  Reporting of results
    11. 11.     We came to their group Help re local language Helped us make it more comfortable for participants Info that later helped us interpret data
    12. 12. Does confidentiality mean…  No interviews in public places, even if that’s what participants request?  Kicking Grandma out of the room?  Pretending you don’t see participant in public?
    13. 13.   Some found it emotionally draining Too long and redundant    Questionnaires with overlapping questions Categories of services – national vs. local terms Keeping in touch with families every 6 months
    14. 14.  “Evaluating System of Care – not you”   Non-judgmental attitude for better rapport, retention, AND accuracy.   Yet up front about sensitive, personal questions Balance – we can’t act as friends or counselors! If SoC not working, or not working with all groups of people, we need to know.
    15. 15.    Offer breaks, gum, stress balls, etc. to participants Coloring books, DVDs for young kids Redundant questions from multiple surveys: propriety and accuracy trump methodological “letter of law.”
    16. 16.      Family address tracking form Birthday and holiday cards with coupons Incentives for families to contact us Annual dinner as a “thank you” Results in bimonthly newsletter, website, and other venues
    17. 17. African Americans 00 Caucasians 19.1% 00 Participants Partcipants 22.8% 77.2% NonParticipants Chi Square (1, N=224) = .466, p = .495 80.9% NonParticipants
    18. 18. African American Caucasian 00 00 Participants 27.9% Participants 22.1% 72.10 NonParticipants 77.9% Chi Square= (1, N= 145) = .665, p = .415 NonParticipants
    19. 19. African American Caucasian 00 00 Participants 36.8% Participants 30.6% 63.2% NonParticipants Chi Square= (1, N=119) = .511, p = .561 69.4% NonParticipants
    20. 20. African American Caucasian 00 00 Participants 40.4% Participants 43.2% 59.6% NonParticipants Chi Square= (1, N=91) = .071, p = .834 56.8% NonParticipants
    21. 21. African American Caucasian 00 00 Participants 37.9% 47.8% 52.2% Participants NonParticipants 62.1% Chi Square= (1, N=52) = 1.055 , p = .402 NonParticipants
    22. 22.   Fulfilling national evaluation requirements within a local context is a constant balancing act. With enough input from local stakeholders at each stage, it can be achieved!
    23. 23.     Please contact carolyn.sullins@wmich.edu Or Ladel_lewis@yahoo.com For more info, please see also http://www.wmich.edu/sociology /kzoowraps.html

    ×