Consumer Quality Index for Consumer Quality Index for Shelter Services Shelter Services Measuring client experiences with shelter services Measuring client experiences with shelter services for homeless adults, homeless youth and battered for homeless adults, homeless youth and battered women women in the Netherlands in the Netherlands Judith Wolf Judith Wolf Mariëlle Beijersbergen Mariëlle Beijersbergen Jolanda Asmoredjo Jolanda Asmoredjo Milou Christians Milou Christians Research Centre for Social Care (Omz) Research Centre for Social Care (Omz)
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The Psychometric Qualities of a Consumer Quality Index Assessing Clients’ Experiences with Services for Homeless People, Homeless Youth and Battered Women
Presentation given by Marielle Beijersbergen, Jolanda Asmoredjo & Judith Wolf, The Netherlands at a FEANTSA Research Conference on "Understanding Homelessness and Housing Exclusion in the New European Context", Budapest, Hungary, 2010
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Consumer Quality Index for Shelter Consumer Quality Index for Shelter ServicesServices
Measuring client experiences with shelter services Measuring client experiences with shelter services
for homeless adults, homeless youth and battered women for homeless adults, homeless youth and battered women
Research Centre for Social Care (Omz)Research Centre for Social Care (Omz)
1. Background
2. Pilot survey
3. Psychometric analyses
4. Multilevel analyses
5. Adjusted instrument
6. Future developments
Content
What is a Consumer Quality Index?
• Standardised method to measure client experiences with health care.
• Strict guidelines for development, use of instrument, data analyses and reporting (developed and monitored by Centre for Client Experience with Care - CKZ).
• Two types of CQ-questionnaires: experience and importance
• Measurements can be used for internal quality control and external accountability purposes.
• Information for clients, shelter organisations, government, etc.
1. Background
Importance of a CQI for shelter organisations
• Little known about how clients experience shelter services
• Little known about what clients find important about care
• Sector uses variety of instruments:• developed for other target groups• no standardised instruments (reliability, validity, etc)• no comparisons possible
Necessities: • Standardised instrument
• Possibility for benchmarking
1. Background
Preparatory research pilot CQI Shelter services Sources:
• Literature search
• Expert interviews
• Focus group discussions with stakeholders (clients, workers)
• Concept mapping method (clients, workers)
Process:
• Pre-pilot & pilot survey
• Monitored by Centre of Client experiences with Care (CKZ) &
advisory council
1. Background
2. Pilot survey
• 3 target groups: battered women, homeless adults and homeless youth (20 shelter facilities per target group)
• 2 versions of CQI-SS: ambulant (67) & residential (78)
• Pilot questionnaire: 42-52 items on clients’ experience: - Contact with worker
- Appropriate care & counselling - Information - Children
- Received care - Outcomes of care - Living conditions (residential version)
• Standard CQI answer categories: 1=never - 4=always
2. Pilot survey
Response pilot questionnaire
• 848 744 questionnaires to be used (+ 116 retest)
• Battered women 34%
• Homeless adults 37%
• Homeless youth 29%
• 12 respondents per shelter
3. Psychometric analyses
Factory analyses
Table: Cronbach’s alphas per CQI scale
Scale (nr. items) Total (N)
Hom. adults
(N)
Bat. women
(N)
Hom. youth
(N)
Client-worker interaction (4)
.84 (693)
.85 (269)
.81 (246)
.86 (215)
Received care (10)
.90 (693)
.90 (255)
.89 (231)
.91 (207)
Outcomes of care (5)
.87 (709)
.87 (264)
.87 (237)
.86 (208)
Living conditions (residential) (6)
.77 (499)
.79 (207)
.72 (183)
.77 (109)
• 3-4 reliable scales (Cronbach alphas .72 - .91)
3. Psychometric analyses
Scale Total (NRange=114-115)
Homeless adults
(NRange=57-58)
Battered women
(NRange=57-58)
Client interaction .67 .62 .71
Received care .67 .69 .66
Outcomes .52 .59 .47
Living conditions (residential)
.62 .54 .69
Retest stability
Table : Pearson’s Correlations Test-retest: sufficiently reliable over time
4. Multilevel analyses
Table: Intraclass correlations (ICC’s)
Scale N clients (units)
ICC ICC controlled*
Client-worker interaction
Homeless adults 266 (18) .23** .17**
Battered women 231 (24) .03 .03
Homeless youth 216 (18) .15** .16**
Received care
Homeless adults 266 (18) .37** .31**
Battered women 231 (24) 0 0
Homeless youth 216 (18) .23** .22**
Results of care
Homeless adults 266 (18) .20** .15**
Battered women 231 (24) .05 .02
Homeless youth 216 (18) .07* .06
Living conditions (residential)
Homeless adults 213 (14) .35** .20**
Battered women 193 (20) .11* .11*
Homeless youth 117 (10) .16* .15*
• Controlled for client background characteristics influencing CQI score
Content CQI-SS
• Background questions
• (Living conditions in shelter)
• Client-worker interaction
• Received care
• Results of care
• Overall opinion of facility (grade 0-10)
• Final questions
5. Adjusted instrument
Scale Number of items
Example
Client-worker interaction
4 Does the employee take you seriously?
Received care 10 Do you receive as much assistance as you need?
Results of care 5 As a result of the assistance, are you able to make better decisions about your life?
Living conditions (residential)
6 Is it clean in the facility?
Separate items 13 - Do you receive advice about your safety?
- Have any agreements been made with you about the supervision of your children?
- How do you rate this facility? 0 means: really poor. 10 means: excellent