Transcript Kimberly Jacob Arriola, Ph.D., MPH, Emory

Outcome Evaluation of the
Shelter-A-Family Program
Kimberly Jacob Arriola, PhD, MPH
Associate Professor
November 20, 2013
3rd Annual Georgia Supportive Housing Association Conference
SAF Program Staff
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Joyce Sloan, LCSW-Program Director
Naomi Haynes, MSW-Program Manager
Ja’Nai Johnson, MSW-Coordinator
Nefertari I, BSW-Case Manager
Ronterius Sanders, MS-Case Manager
Stacie Fitzgerald, LCSW-Counseling Manager
Pamela Crosling, MS-Substance Abuse Counselor
Shondella Andre, BA-GED Instructor
Today’s Agenda
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Overview of the program
Purpose of the outcome evaluation
Evaluation methods
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CMHS TRAC NOMs
Staff-administered supplemental evaluation
interview
Findings & limitations
Conclusions
Program Description
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SAF is a community-based, supportive housing program
for families with children who have experienced:
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long-term homelessness
where the head of household suffers with disabilities of:
*mental illness
*substance abuse and/or
*HIV/AIDS
Provides site-based supportive services
to 43 families in HUD-funded
apartment units in NW Atlanta
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Program Goals
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To help formerly homeless individuals:
Reduce
and eliminate substance dependency and use
Achieve mental and emotional stability
Move toward greater self-reliance
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To promote child safety and development
To prevent future homelessness among
children traumatized by:
Homelessness
Abuse
& neglect
Parent’s substance abuse and MH challenges
Eligibility
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Must be experiencing long-term homelessness, as
defined by HUD
Very low income
Verifiable disability, as defined by HUD, of mental
illness, substance abuse, or HIV or AIDS
Must be a family with child(ren) under the age of 18
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Single female headed households
Single male headed household
Two parent, married household
Supportive Services
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Intensive case management
Home –based counseling sessions
On-site substance abuse individual & group treatment
Life skills training
Mental health support groups for adults and youth
Provide access to resources, including health, asset development,
and linkages to community activities & groups
On-site GED instruction, educational and employment supports,
job search assistance
Assertive Community Treatment (ACT) Team meetings
Monthly community meetings
Program Modification
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SAF I
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Established in 2005
June 1, 2009 received
additional funding from
SAMHSA to provide
site-based supportive
services
Adopted Housing First
Model.
23 families in current
analyses
SAF II
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Effective February 1, 2013
20 families that were
consolidated into existing
SAF program
Initially resided at Delowe
Village
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Families First Project
G.R.O.W. Program
Outcome Evaluation
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To explore change in clients based on:
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Housing stability
Physical and mental health and sense of wellbeing
Dependence on illegal and harmful substances
Academic, vocational, life and social skills, and
income
Perceived family & community support
Outcome Evaluation Constructs
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CMHS TRAC NOMs
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Demographic data
Functioning
Stability in housing
Education and
employment
Crime and criminal
justice
Social connectedness
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Evaluation Interview
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Medical status and
health insurance
Drug/alcohol use
Psychiatric status
Health and well-being
Child well-being
Outcome Evaluation Constructs
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CMHS TRAC NOMs
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Demographic data
Functioning
Stability in housing
Education and
employment
Crime and criminal
justice
Social connectedness
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Evaluation Interview
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Medical status and
health insurance
Drug/alcohol use
Psychiatric status
Health and well-being
Child well-being
CMHS TRAC NOMs Instrument
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Baseline Assessment conducted within 7 days
of program enrollment
Reassessment interview conducted every 6
months (+/- 30 calendar days)
Administered by staff
CMHS TRAC NOMs Data
Assessment
Baseline
6 month assessment
12 month assessment
18 month assessment
24 month assessment
30 month assessment
36 month assessment
Clinical Discharge
(as of 8/1/13)
Number of Assessments
55
31
29
24
19
14
11
17
Supplemental Evaluation Interview
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Largely based on the Addiction Severity Index
(McGahan, Griffith, Parente, & McLellan, 1986)
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Key domains
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Medical status and health insurance;
Drug/alcohol use;
Psychiatric status;
Health and well-being
Child well-being
Administered by staff after TRAC NOMs
Supplemental Evaluation Interview
(as of 8/1/13)
Assessment
Baseline
6 month follow-up
12 month follow-up
18 month follow-up
24 month follow-up
30 month follow-up
Interviews Conducted
44
26
20
12
9
5
Client Demographics
Client Characteristics
Gender
Female
Marital Status
Single
Unknown
Age
0-17 years
18-36 years
37+ years
Race/Ethnicity
Black
(based on service utilization data)
SAF (N=86)
Client n (%)
SAF II (N=58)
Client n (%)
49 (57)
38 (66)
26 (30)
55 (64)
16 (28)
42 (72)
38 (44)
25 (29)
20 (23)
35 (61)
14 (24)
9 (15)
75 (87)
55 (95)
Results: Housing Stability
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TRAC NOMs
“In the past 30 days,
where have you been
living most of the
time?”
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Owned or rented house,
apartment, trailer, room
Results: Physical Health
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TRAC NOMs
“How would you rate
your overall health
right now?”
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Excellent or very good
Results: Functioning
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TRAC NOMs
8 separate items
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Response options
ranged from 1 (SD) to 5
(SA)
Percent who strongly
agree
Results: Emotional Health
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Supplemental
Evaluation Interview
“How many days in the
last 30 days have you
experience these
psychological or
emotional problems?”
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E.g., serious
depression,
hallucinations, serious
anxiety or tension
Results: Substance Use
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Random drug
screens
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170 screens
performed on 31
clients
Based on service
utilization data
Number of
clients screened
Number of
screens
Positive
Negative
Inconclusive
Percent positive
SAF I
21
SAF II
10
121
49
9
61
51
7%
15
27
7
31%
Results: Academic, Vocation,
Social Skills
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TRAC NOMs
“Are you currently
enrolled in school or a
job training program?”
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Not enrolled or
Enrolled full or part
time
Results: Social Connectedness
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TRAC NOMs
4 items
E.g., “I am happy with
the friendships I have”
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Response options
ranged from 1 (SD) to 5
(SA)
Percent who strongly
agree
Limitations
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Study design
Small numbers of participants
Effect sizes
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Consolidation of 2 programs
Child well-being data
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Limited number of children in which there are 2
or data points that are clearly linked to a
particular child
Conclusions
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Clients are largely achieving stable housing
Indicators of adult well-being show improvement over time
Lower rates of drug use were found among SAF I clients
(7%) than among SAF II clients (31%)
Enrollment in an academic, vocational, or job skills program
has remained somewhat flat over time
Participants reported greater satisfaction with their
friendships at 36 months, but other measures of social
connectedness did not yield clear patterns.
Thank You!
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Kimberly Jacob Arriola
RSPH of Emory University
1518 Clifton Road, NE
Room 520
Atlanta, GA 30322
[email protected]
404-727-2600