progress tracking system for transition to adulthood...
TRANSCRIPT
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Progress Tracking System for
Transition to Adulthood Programs:
Research-Informed Implementation
Strategies
March 4, 2014
Michael A. Harnar, Ph.D. Hewitt “Rusty” Clark, Ph.D. Prashant Rajvaidya, Ph.D.
Outline
1. TAPIS Progress Tracker and Goal Achiever
2. Example of findings from a new TIP model site implementation.
3. Implementation and Evaluation Theories in Data System Implementations
4. Impacting Program Development
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Purpose
To assist community-based transition programs in better serving the needs of the youth and young adults with SMHCs & related needs by:
Tracking YP’s progress or difficulty
over time.
Guiding transition planning.
Determining medical necessity.
Providing data for continuing system
improvement.
TAPIS Progress Tracker Transition Domains
Employment and Career
Education
Living Situation
Personal Effectiveness and Wellbeing
Interpersonal Relationships
Emotional and Behavioral Wellbeing
Physical Health and Wellbeing
Parenting
Community Life Functioning
Daily Living
Leisure Activities
Community Participation
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TAPIS Goal Achiever
Purpose
To allow young person to work with transition facilitator to establish and monitor his/her own individualized goals
Set and track individualized goals
Domains match Progress Tracker
Identify tasks needed to achieve goal
Evaluate progress over time
What is the TIP Model?
The Transition to Independence Process model is an
evidence-supported practice that engages YP (ages 14-
29) in their own futures planning process, provides them
with individually-tailored supports/services, and involves
them (& others) in a process that prepares & facilitates
their:
o greater self-sufficiency and
o successful achievement of own goals.
www.TIPstars.org
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TIP Model Guidelines
Practice Level
YP & Informal / Formal Key Players
Program Level
Community System Level
State & Federal Policy Level
www.TIPstars.org
1. Engage young people through relationship development, person-centered planning, and a focus on their futures.
2. Tailor services and supports to be accessible, coordinated, appealing, non-stigmatizing, and developmentally-appropriate -- building on strengths to enable the young people to pursue their goals across relevant transition domains. 3. Acknowledge and develop personal choice and social responsibility with young people.
1. Engage young people through relationship development, person-centered planning, and a focus on their futures.
2. Tailor services and supports to be accessible, coordinated, appealing, non-stigmatizing, and developmentally-appropriate -- building on strengths to enable the young people to pursue their goals across relevant transition domains. 3. Acknowledge and develop personal choice and social responsibility with young people.
www.TIPstars.org
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1. Engage young people through relationship development, person-centered planning, and a focus on their futures.
2. Tailor services and supports to be accessible, coordinated, appealing, non-stigmatizing, and developmentally-appropriate -- building on strengths to enable the young people to pursue their goals across relevant transition domains.
3. Acknowledge and develop personal choice and social responsibility with young people.
4. Ensure a safety-net of support by involving a young person’s parents, family members, and other informal and formal key players. 5. Enhance young persons’ competencies to assist them in achieving greater self-sufficiency and confidence. 6. Maintain an outcome focus in the TIP system at the young person, program, and community levels. 7. Involve young people, parents, and other community partners in the TIP system at the practice, program, and community levels
www.TIPstars.org
Employment
& Career
Living
Situation
Educational
Opportunity Functioning
Personal
Effectiveness
& Wellbeing
TIP Model Transition Domains
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TIP Model Core Practices
Strength Discovery and Needs Assessment
Futures Planning
Rationales
In-vivo Teaching
Social Problem Solving (SODAS)
Prevention Planning Process on High Risk Behaviors
Mediation with Young People and Other Key Players
www.TIPstars.org
Our focus is on: Implementation of TIP Model to improve the progress & outcomes of YP. Competency-based training & field-based
supports for personnel: front-line & supervisory. Supervisory coaching methods. TIP Solutions Review process. Strong youth & young adult voice. (e.g., Hire
Peer Mentors; YP, family, & partners in governance).
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Our focus is also on:
Sustainability. Building community partnerships across
child/adult systems & other community organizations.
Establishing Site-Based Trainers.
Fidelity Quality Improvement Assessment. Establish local assessors for ongoing fidelity quality
improvement assessment.
TA on evaluation systems for tracking YP’s progress.
• Transition to Independent Process (TIP) Model
• TIP Model Website: www.TIPstars.org
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TIP Model Implementation Progress & Outcome Indicators on Young People
Initial Implementation of TIP model in Muskegon County, MI.
Transition Age Services (TAS) team at Muskegon County Community Mental Health is the lead TIP entity.
First 15 months of implementation.
Building community collaborative across mental health, family court, probation, homeless/runaway, & child welfare: Muskegon County TIP Model Collaborative.
TAS team started small with a clinical supervisor & two TFs. Team growing slowly, but over time will be adding more TFs & Peer Support Associates.
TAS team very attentive to TIP model implementation (e.g., supervisory coaching, TIP Solutions Reviews).
TIP Model Implementation First 12 months of TIP model supports and services.
TAS Transition Facilitators (TFs) working with 29 youth & young adults over first 12 months.
Main referrals from court, juvenile justice, & probation.
YP have serious mental health conditions (SMHC) & at risk of, or extensive histories of, out of home placements, co-occurring substance use (e.g., Cannabis Dependence, polysubstance dependence), developmental trauma, &/or multiple-system involvement.
Average age of admission 17 years (range 14-26 years).
Average length of TAS service was about 6 months (range 2-12 months) at the close of this initial evaluation period.
Data collected at intake & close of this evaluation period.
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0%
20%
40%
60%
80%
100%
Living inCommunity
Family orIndependent
Friends orCouch Surfing
Detention,Jail,
Residential orAWOL
Not onProbation
48% 41%
7%
52% 48%
93%
79%
10% 7%
66%
Pe
rce
nta
ge o
f Y
P
TIP Model Implementation: New Site Findings Community Life & Living Situation Progress Indicators
0%
20%
40%
60%
80%
Working orGoing toSchool
AttendingSchool/ GED
Working GraduatedHS/GED
AttendingCollege
24% 24%
0% 0% 0%
69%
52%
21%
10% 7% Pe
rce
nta
ge o
f Y
P
At Intake Current/at discharge
TIP Model Implementation: New Site Findings
Education & Employment Progress Indicators
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Limitations of Initial TAS Implementation Evaluation
Evaluation of the TIP model implementation at a new site.
Some agency leadership experienced with system collaborative development & had done TIP implementation in another state in conjunction with TIP model consultants.
Small team who have the luxury of small caseloads to start. Supervisor provided active supervision, training, office-based & field-based coaching.
Have not conducted fidelity assessment on implementation of the TIP model at this site as of yet.
No control group or comparison group was used. This limits the conclusions about what would typically happen to these YP in this county.
Implications of this Evaluation Study
These evaluation findings further support:
Feasibility of TIP model implementation with YP who have SMHCs. Demonstrate the impact of the the TIP model on these youth & young adults.
Having agency & collaborative leadership committed & somewhat seasoned in system development & the TIP model may have contributed to the initial solid program implementation.
Fidelity assessments early in implementation could be helpful in tracking & guiding early implementation.
TIP Model Theory & Research: www.TIPstars.org
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Research Findings on TIP Model
Six published studies that demonstrate improvement in real-life outcomes for youth and young adults with EBD.
Four studies by our NNYT Research Team at the NNYT, USF.
Two studies by other researchers.
Refer to “Theory and Research” section of the TIP model website.
www.TIPstars.org
We got our start evaluating
a multiagency Systems of
Care initiative with complex
data management needs.
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Technology as a Tool
Real-Time, High-Quality Data
Strategic Thinking & Decision-Making
Improved Services & Collaborations
Improved Outcomes for Families & Communities = A Better World!!
Newborn
Preschool
School-Aged
Teens
Youth Transition
Adults
Seniors
Lifespan Initiatives
Strengthening Families
Making Connections
First 5 CA
Smart Start
Community Action Programs
Domains
Mental Health
Education
Family Support
Employment/Workforce
Housing/Homeless
Community Development
Foundations/NPOs
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Local, Statewide, and National Projects… (and International)
What is ?
Comprehensive software for evaluating and managing complex multi-site initiatives, with:
Client tracking and case management
Contract and fiscal monitoring
Robust outcomes tracking and reporting
Preloaded and ad hoc data queries, reports, and exports
Secure web-based system with local data ownership
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GEMS
Contracts
CM
Family Info
Surveys
Reports
Analyses
TAPIS
YP Info
Surveys
Reports
Analyses
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How do you successfully implement a more limited data tool within an organization?
TAPIS
YP Info
Surveys
Reports
Analyses
Theory-Driven
Evaluation Theory
Implementation Theory
System Implementations
Fidelity
Use
TAPIS validity study
Launch system
Observe use
Develop reports
Improve system
Observe use
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• Participatory Evaluation
– PE
– PTDE (Theory of Change/Outcome Definitions)
• Implementation
– Competency drivers
– Leadership drivers
– Organization drivers
• Decision-oriented data system – System-level
– Tool-level
• GEMS NC Healthy Start
– Many counties, lots of kids
– Regional coordinator
– Key lessons
• Fidelity
• Use
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• Deliver customizable off the shelf system
• Monitor and observe use
– Address fidelity/use questions
• Adjust system and procedures
• Engage longitudinally
– Provide research support
• Keep them focused on fidelity and use issues
• Instrument implementation
– Baseline
– On schedule
– Complete data
– Comprehensive coverage
– Is there confidence in the data?
• System and instrument use capacity building
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• Using system/data to inform the process
– Hands on by Transition Facilitators
– Monitoring outcomes
– Assessing TF productivity
– Actionable items – Dashboard?
• System adaptations
• Capacity building
– Report building
– Data analysis
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Questions?
Michael A. Harnar, Ph.D. Senior Associate, Research and Evaluation Mosaic Network, Inc. [email protected] Hewitt “Rusty” Clark, Ph.D. Director, National Network on Youth Transition for Behavioral Health (NNYT) and Professor Emeritus, University of South Florida [email protected] Prashant Rajvaidya, Ph.D. President, Mosaic Network, Inc. [email protected]