| Session Title: Valuing Participation in a Multi-site, Multi-method Intervention Trial of Housing First in Five Canadian Cities |
| Multipaper Session 802 to be held in California B on Saturday, Nov 5, 8:00 AM to 9:30 AM |
| Sponsored by the Cluster, Multi-site and Multi-level Evaluation TIG |
| Chair(s): |
| Jayne Barker, Mental Health Commission of Canada, jbarker@mentalhealthcommission.ca |
| Abstract: There are many ways in which participation can be a part of a pragmatic randomized multi-site trial of a complex intervention. In order for the results to influence policy and practice it is important to incorporate this approach throughout the project. This session will describe the experiences to date for a $110 million 5 year study that began in 2008. An overview of the study will set the stage for papers describing how the implementation of the Housing First intervention was adapted in response to local needs, how a local research team has operated within a common national framework and how a consumer panel has supported the involvement of persons with lived experience of homelessness and mental illness. |
| An Overview of the At Home/Chez Soi Evaluation Project |
| Paula Goering, University of Toronto, paula_goering@camh.net |
| This paper will describe the overall project design and the rationale for key scientific and operational decisions regarding the first and only multi-site trial of Housing First. The core study aims to learn about the feasibility, effectiveness and costs of implementing Housing First programs in varied contexts. It will randomize 2000 participants who are homeless and have a mental illness into treatment as usual or two intervention arms, Housing First plus Assertive Community Treatment for those with high needs and Housing First plus Intensive Case Management for those with moderate needs. An adaptation in one mid-size city with 200 participants will have one Housing First intervention arm in a combined need group. Another 300 participants will receive unique local interventions. Recruitment was completed in the spring of 2011. A common mixed-methods protocol includes assessments every six months over two years of follow-up. |
| Seeking to Reconcile At Home/Chez Soi National and Local Research Objectives in Montreal |
| Eric Latimer, , eric.latimer@douglas.mcgill.ca |
| The At Home/Chez Soi project was designed and funded at the outset to allow local sites the opportunity to address questions of local interest in addition to a set of core questions common to all sites. This presentation will describe how Montreal investigators interacted with local providers as well as the national research team to produce a unique set of questions and methods in addition to those specified at the national level; how the conduct of the research has involved a constant give and take between the national investigators and the local team, both researchers and research staff; and indeed how input from individual sites often led to changes in policy across all sites. Several examples will be given, ranging from the description of the genesis of specific sub-studies, to the selection of psychometric instruments, to agreements regarding publications. |
| Managing the Implementation of At Home/Chez Soi as a Collaborative Exercise |
| Cameron Keller, Mental Health Commission of Canada, ckeller@mentalhealthcommission.ca |
| Implementation of At Home/Chez Soi across sites included identifying and contracting with service agencies to provide housing and service supports as well as providing technical assistance and training about Housing First. Attention was paid to effective strategies for mental health best practice implementation. However, implementation also varied somewhat across sites due to a variety of factors including political influences, size and capacity of service providers, local cultural needs and influences, local support offered by the funder (Mental Health Commission of Canada), the presence of a local "champion" etc. In all cases, collaboration between multiple research and service agencies during development and implementation was essential for success, although the extent and type of collaboration varied. This paper describes the critical role of the "Site Coordinator", a change agent position developed to facilitate and support collaborations that were sensitive to local city context and yet shared a common purpose and form. |
| Experience Matters: Making the At Home/Chez Soi National Consumer Panel |
| Jijian Voronka, University of Toronto, jvoronka@mentalhealthcommission.ca |
| This presentation begins with the theoretical imperative for the involvement of people with lived experience (PWLE) of mental health and homelessness in research and service provisions. I will then talk about the practical implementation considerations when developing the National Consumer Panel, a group constituted and run by PWLE, which acts in an advisory capacity to the project. I will further discuss the ways in which the Panel has worked to meaningfully inform a diversity of topics, including evaluation of the relevance and appropriateness of research scales, concerns about media representation, and supporting PWLE as advisors and project employees. I will end by discussing the importance of the Panel generating self-initiated measures, such as training recommendations, knowledge exchange, and the writing of discussion reports that are used to inform the project as a whole. |