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Intended Uses of Evaluation Findings for Intended Users OAE Team Meeting October 2011 M E N T A L H E A L T H C E N T E R O F D E N V E R www.mhcd.org
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Utilization Based Evaluation In Mental Health

Jun 30, 2015

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Paul Frankel
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Page 1: Utilization Based Evaluation In Mental Health

Intended Uses of Evaluation Findings for Intended Users

OAE Team Meeting

October 2011

M E N T A L H E A L T H C E N T E R O F D E N V E Rwww.mhcd.org

Page 2: Utilization Based Evaluation In Mental Health

“If you don’t measure results, you can’t tell success from failure.”

o Stakeholders: Who has a “stake?”o Making the case for “utility”o Research & Decision Makingo Resistance is futile!o Topics for Discussion

M E N T A L H E A L T H C E N T E R O F D E N V E Rwww.mhcd.org

Page 3: Utilization Based Evaluation In Mental Health

Who are our Stakeholders & Intended Users?

“We are certain that the evaluation will completely meet the informational needs of absolutely everyone.”

Page 4: Utilization Based Evaluation In Mental Health

Different intended users may have different and multiple information needs

Page 5: Utilization Based Evaluation In Mental Health

“…to ignore Stakeholders is like ignoring a smoldering dynamite fuse…”

Intended users are more likely to use evaluations if they understand and feel ownership of the evaluation process and findings. Do we practice this?

Stakeholders’ commitment to evaluation is fragile. Do you agree?

“I would really like to know _________ about Program X at MHCD.”

M E N T A L H E A L T H C E N T E R O F D E N V E Rwww.mhcd.org

Page 6: Utilization Based Evaluation In Mental Health

M E N T A L H E A L T H C E N T E R O F D E N V E Rwww.mhcd.org

KNOWING: “What’s So?”

ACTION: “So What?”

• Design studies• Methods &

Statistics• Collect data• Publish

Using Information in the Information Age

• Decision making• Standards:

o Utilityo Feasibilityo Proprietyo Accuracy

Page 7: Utilization Based Evaluation In Mental Health

“…we have reached a level where we know what we are doing and have a track record of important contributions…”

Eminently Practical:Evaluations should be judged by their utility and actual use.How real people in the real world apply evaluation findings and experience the evaluation process.

M E N T A L H E A L T H C E N T E R O F D E N V E Rwww.mhcd.org

Evaluation Use: Both Challenge & Mandate

Page 8: Utilization Based Evaluation In Mental Health

“We did not get the information we needed when we wanted it, and it wasn’t what we wanted when we got it.”

This scene is repeated over-and-over.A critical public issue (affects MILLIONS

of People and BILLIONS of Dollars).How are programs that combat societal

ills (poverty, drugs, etc.) to be judged? “…reports gather dust on bookshelves…”

M E N T A L H E A L T H C E N T E R O F D E N V E Rwww.mhcd.org

What do we have to do to get results we can really use?

Page 9: Utilization Based Evaluation In Mental Health

A man walking along the street notices another man with bananas in his ears. He Shouts, “Hey, mister, why do you have bananas in your ears?”

Receiving no response, he pursues the man, calling again as he approaches, “Pardon me, why do you have bananas in your ears?” Again there is no response. He catches up to the man, puts his hand on his shoulder, and says, “Do you realize that you have bananas in your ears?”

The gentleman in question stops, looks puzzled, takes the bananas out of his ears and says, “I’m sorry, what did you ask? I couldn’t hear you because I have bananas in m years?”

Page 10: Utilization Based Evaluation In Mental Health

Can STAKEHOLDERS be blamed for NOT reading the reports?

Knowledge use: Getting people to apply what is already known (seatbelts, smoking, contraception, helmets).

• e.g., Medical compliance: Why so many people don’t follow their doctor’s orders?

M E N T A L H E A L T H C E N T E R O F D E N V E Rwww.mhcd.org

“Agency Evaluation ReportsDisregarded by Legislators…”

Page 11: Utilization Based Evaluation In Mental Health

Implementation Evaluation “Programs, like airplanes, need all their

parts to do what they are designed to do and accomplish what they’re supposed to accomplish. Programs, like airplanes, are supposed to be properly equipped to carry out their assigned functions and guarantee passenger (participant safety). Programs, like airplanes, are not always so equipped. Regular, systematic evaluations of inventory and maintenance checks help avoid disasters in both airplanes and programs.”

Page 12: Utilization Based Evaluation In Mental Health

Knowledge Use

Page 13: Utilization Based Evaluation In Mental Health

New Directions in Accountability

“What gets measured gets done.”

Outcomes

Desired

Long-term Results

Consumers’ Lives

Affected

Page 14: Utilization Based Evaluation In Mental Health

M E N T A L H E A L T H C E N T E R O F D E N V E Rwww.mhcd.org

Problematic Outcomes: What’s in it for the Consumer?

“Develop a supportive, family-centered, culturally competent, capacity-building intervention for families and children.”

OUTCOME 1

“To continue implementation of a case management system to maintain contact with clients before, during, and after treatments.”

OUTCOME 3

“Adults with serious and persistent mental illness will engage in a process to function effectively in the community.”

OUTCOME 2

“Improve ability of adults with developmental disabilities to begin making decisions and exercise choice.”

OUTCOME 4

Page 15: Utilization Based Evaluation In Mental Health
Page 16: Utilization Based Evaluation In Mental Health

M E N T A L H E A L T H C E N T E R O F D E N V E Rwww.mhcd.org

Utilization Outcomes

Target subgroup Teenage fathers at Mumford High

Desired outcome Appropriate parenting knowledge and practices

Outcome indicator Score on parent practice inventory (knowledge and behavior subscales)

Data collection Pre- and posttest; 6 month follow-up by District

Performance target 75% of participants will complete the program and attain a passing score on posttest subscales

USE Task force of varied stakeholders will review results and decide if program should continue and be expanded to other schools; Recommendations forwarded

Page 17: Utilization Based Evaluation In Mental Health

M E N T A L H E A L T H C E N T E R O F D E N V E Rwww.mhcd.org

o Our project is uniqueo The program ‘aint broken’ o Evaluation could trigger threatening consequenceso Evaluation is a hassle o The study is seen as impossibleo It’s not in my job to participateo What’s in it for me?o Not enough money to do a good job (1% 5% ?)o Project plan/SOW is vague o Staff or leadership has changedo Been there, done that, we don’t need to do it again

Resistance to Evaluation

Resistance is Futile!

Page 18: Utilization Based Evaluation In Mental Health
Page 19: Utilization Based Evaluation In Mental Health

M E N T A L H E A L T H C E N T E R O F D E N V E Rwww.mhcd.org

Situational Dimensions Affecting Stakeholder & Evaluator Engagement

● Utility ● Feasibility ● Propriety ● Accuracy

Distant CloseRelationship w/ primary intended Users

Directed ConsultantControl of the evaluation process

Audience All AspectsScope of intended User involvement

None ConstituenciesNumber of Stakeholders engaged

Deadlines DevelopmentalTimeline

Page 20: Utilization Based Evaluation In Mental Health

M E N T A L H E A L T H C E N T E R O F D E N V E Rwww.mhcd.org

Possible Future Discussion Topicso Who are the Stakeholders at MHCD?o Research vs. Evaluationo Must an evaluation be useful?o Ambiguity in outputs and outcomeso Are logic models useful?o Overcoming resistance to evaluationo Are MHCD evaluations useful?

How do we know?