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National Child Traumatic Stress Initiative (NCTSI) Data and Evaluation Webinar Webinar Overview Overview of data and evaluation for the NCTSI: National Center for Child Traumatic Stress (NCCTS) Data and Evaluation Program/Core Data Set (CDS) Cross-site Evaluation Transformation Accountability (TRAC) NCCTS Data and Evaluation Program Range of quality improvement, data collection, and evaluation initiatives CDS: Captures quantitative data on Network-supported treatments and services Types of traumatic events Treatments delivered Functioning of youth over time Cross-site Evaluation Eight study components: Child and family outcomes and satisfaction with services Network functioning with regard to trainings, collaboration, product development, and product adoption and dissemination TRAC TRAC: Uniform tool for collecting data on mental health outcomes across programs Grantees are required to collect TRAC data as part of SAMHSA’s reporting obligations NCCTS Data and Evaluation Program: Overview and Next Steps Ernestine Briggs-King, Ph.D. National Center for Child Traumatic Stress Duke University School of Medicine Objective: How Do All the NCTSI Data Collection Initiatives Fit Together? SAMHSA initiatives QPR TRAC MACRO International Initiatives Cross-site Evaluation NCTSN Member sponsored initiatives Surveys Data & Evaluation Program Initiatives Core Data Set eSUF, Metrics, Product Evaluation Data and Evaluation Program Ernestine Briggs-King, Ph.D. 919-682-1552, ext. 254 [email protected] Bart Evans, B.S. Project Leader 919-668-8981 [email protected] Rebecca Wilgus, RN, M.S.N. 919-668-8897 [email protected] Data and Evaluation Program: What Do We Do? The Data and Evaluation Program is broadly concerned with data collection, analysis, and dissemination. The Duke Clinical Research Institute (DCRI) provides the following services: ●Data operations (includes project management, regulatory, contracts, finance) ●Data management ●Data coordinating activities The NCTSN Data Repository is housed at the DCRI. Data Operations Committee includes key members from NCTSN Centers, SAMHSA, Macro, UCLA, and Duke. Data and Evaluation Program: What Do We Do? Regulatory Issues Data Collection Initiatives ● Electronic Service Utilization Form (eSUF) •Aggregate data on clients, services, and trainings ● NCTSN member-driven data collection initiatives •Surveys (e.g., New Grantee Surveys) •Product evaluation •Collaborative group initiatives ● Evaluation •Training, implementation, and dissemination efforts ● Core Data Set (CDS) •Client-level data about youth and families served Introduction: CDS Quality improvement initiative Network-wide data collection that will provide answers to central Network questions Essential for ensuring that the work done in the Network is systematically measured, disseminated, and recognized Numerous benefits for participating clinicians, individual sites, and the Network as a whole ● Clinical improvements and utility ● Real-time reports ● Sustainability NCTSN Clinical Summary Report What is in the CDS? Demographic and living situation information Trauma history and detail Indicators of severity Treatment services and interventions Standardized assessment measures Behavioral and Emotional Difficulties ● Child Behavior Checklist ● UCLA PTSD Reaction Index ● Trauma Symptom Checklist for Children-Alternate CDS measures: administered at treatment entry, end of treatment (if short-term) or every 3 months Bidirectional Data Flow ● All centers will have continuous (interactive) access to client-level reports (i.e., scoring of measures, summaries of client history) ● All centers will have continuous (interactive) access to data status reports that describe data entered by their center ● Each center can receive from Data Repository a ready-toanalyze data set of its own data Next Steps: Data Collection Data collection and data entry resource requirements are determined by your implementation strategy ●Real-time—Clinicians collect and enter data online during assessment of client and family ●Ex post facto—Clinicians collect data on paper during their assessment, and data entry staff enter data into InForm at a later date ●Hybrid model—Combination of above models What will work best at your center?? Next Steps: Regulatory Processes Start the regulatory process soon!! • • • • • Assign a “point person” Obtain documentation from your IRB Submit a Public Health Information Letter Signed Data Use Agreement Templates, roadmaps and technical assistance are available - Web site: www.nctsn.org - Data and Evaluation staff: Just a phone call away! If your center is not affiliated with a local IRB, the DUHS IRB may serve as your IRB of record. Contact Bart Evans at the Data and Evaluation Program for more information. Next Steps: Training Training—Technology How to use the InForm system Training—Clinical Content How to complete the case report forms How to administer the standardized assessments NCTSN Data and Evaluation Program’s Commitment to You • Customer support DCRI EDC Help Desk: [email protected] Phone: 888-372-7743 NCTSN Data and Evaluation Team: [email protected] Phone: 919-668-8182 • Technical consulting and training • Clinical expertise and guidance Data and Evaluation Webinar Overview: Data Collection and Evaluation Activities Introduction to Macro Macro International • Management and consulting research organization – More than 1,000 employees – Multiple offices in the United States and overseas – Many contracts with local, State, and Federal governments (80–90 percent of Macro’s work) • More than 40 years as a government contractor – – – – Applied health services research Information technology Organizational development Communications 20 The Common Goal To raise the standard of care and improve access to services throughout the United States for children and adolescents and their families who have experienced trauma 21 Monitoring and Evaluating the NCTSN Evaluation has always played a large role in the NCTSN Initial congressional authorization required a “rigorous evaluation plan” for each center (P.L. 106-310, 2001) Evaluation plans were to include methods for assessing the effectiveness of: • Processes • Treatment/intervention outcomes 22 What is Cross-site Evaluation (CSE)? NETWORK LEVEL Network Collaboration Adoption and Implementation Product Development and Dissemination Study NREPP Descriptive and Clinical Outcome Study Satisfaction Study CLIENT & FAMILY LEVEL National Impact TraumaInformed Services 23 History of NCTSN Growth and CSE Participation 10 new grantees join NCTSN 5 grantees continue on consecutive awards 44 grantees currently funded 80 grantees ever funded Macro wins competitive bid to conduct CSE Macro begins year of evaluation design, development, and review 53 grantees currently funded OMB approves CSE design Macro begins implementing CSE 44 grantees currently funded 70 grantees ever funded 36 grantees currently funded 16 new grantees join NCTSN 12 grantees continue on consecutive awards 44 grantees currently funded 70 grantees ever funded 20 grantees currently funded NCTSI program authorized under Children’s Health Act of 2000 2000 2001 2002 2003 2004 2005 2006 CSE implementation ongoing 44 grantees currently funded 70 grantees ever funded 5 new centers join NCTSN 3 grantees continue on consecutive awards 54 grantees currently funded 85 grantees ever funded 2007 2008 Fiscal Years Note: Counts of “currently funded” grantees exclude the National Center for Child Traumatic Stress 24 Continuum of Training and Technical Assistance EVALUATION LIAISON SUPPORT MONTHLY UPDATES Regional Training Reviewing Details of the Cross-site Evaluation Individual Training and Technical Assistance Creating Centerbased Strategies for Implementation Cross-site Procedures Manual Componentspecific Updates by E-mail/Ongoing Consultation Steps Toward Implementation Ongoing Technical Assistance 25 Getting Started: Practical Help Tips Getting Started Engaging Stakeholders in the Evaluation • Staff members • Community members • Other relevant stakeholders Ensuring Organizational Readiness • Staff hiring plan and roles • Staff orientation to grant activities • Communication with current grantees Beginning Institutional Review Board (IRB) Process • Local IRB plans • Local IRB application process and deadlines 27 Getting Started (cont.) Study Component Data Sources Who Collects Data Who Responds Timeframe for Implementing Local IRB Center Family consumers FY 2006 and ongoing thereafter Involves local IRB submission Macro Family consumers FY 2006 and ongoing thereafter Core Clinical Characteristics Forms* 1. Descriptive and Clinical Outcomes of Children Receiving Direct Clinical Mental Health Services TSCC-A* UCLA PTSD Index for DSM-IV* CBCL (1.5-5; 6-18)* 2. Consumer Satisfaction With Direct Clinical Mental Health Services 3. Provider Knowledge and Use of Trauma-informed Services 4. Product/Innovation Development and Dissemination YSS-F Key informant interviews and focus groups Macro TIS Survey Centers’ quarterly progress reports and annual progress reports Collaborative group leader interviews Providers Administrators Macro Case studies 5. Adoption of Methods and Practices GAAS Macro AIFI Network Survey 6. Network Collaboration 8. NREPP Collaborative group leaders Network staff, nonNetwork staff Administrators, providers, evaluators Administrators, providers Administrators Macro CTPT survey 7. National Impact of the NCTSI Center-defined experts National Impact Survey Macro Incorporated into regular Network reporting mechanisms Macro Collaborative group members Professional organization members Not applicable FY 2006 and early FY 2007 FY 2008 and ongoing thereafter FY 2006 and ongoing thereafter FY 2006 and FY 2008 FY 2007 and FY 2009 Depends somewhat on local IRB; however, likely no implications FY 2006 and annually thereafter FY 2008 and annually thereafter FY 2006 and FY 2008 FY 2007 and FY 2009 FY 2006 and annually thereafter No implications Ongoing monitoring process No implications 28 Contact Information • If you have questions or comments or need more information, feel free to contact the following members of the CSE team: –Christine Walrath, Officer in Charge E-mail: [email protected] –John Gilford, Project Director E-mail: [email protected] –Bhuvana Sukumar, Deputy Project Director E-mail: [email protected] 29 Center for Mental Health Services (CMHS) and Performance Management NCTSI CMHS Transformation Accountability (TRAC) Agenda • Performance management and CMHS • TRAC and NCTSI • Next steps CMHS Performance Management NCTSI Eval CMHS TRAC National Outcome Measures (NOMs) PART Review GPRA SAMHSA Federal/4 yrs Federal/Annual TRAC Overview CMHS-TRAC is a Web-based, centralized, data platform that collects and reports outcome measures on CMHS programs for the Government Performance and Results Act (GPRA). TRAC: A New Approach to Accountability • TRAC is a strategic imperative for CMHS • Driven by: – Government-wide requirements – SAMHSA data strategy – Center commitment to performance management • Outcome measures targeted at: – Consumer services – Technical assistance – Infrastructure development – Prevention SAMHSA-wide Domains: NOMs SAMHSA is obtaining OMB approval to use NOMs for GPRA reporting purposes: – – – – – – – – – – Functioning Stability in Housing Employment and Education Crime and Criminal Justice Status Perception of Care Social Connectedness Access/Capacity Retention *Cost-effectiveness *Use of Evidence-based Practices *Indicates that measures have not yet been developed for these domains CMHS GPRA Data Collection: Current Status Most programs were collecting GPRA data in some form Lack of standardized outcome data: – Limits the ability to demonstrate what CMHS has achieved – Creates difficulties in aggregating data to summarize program performance NOMs tool is now the standard data collection method for all service programs TRAC and NCTSI Service Treatment Grants • NOMs tool used to collect interviews on all consumers enrolled in services: – Paper NOMs tool/electronic NOMs tool • Data collection points—baseline, reassessment, and discharge • Reassessment is collected every 3 months while consumer is receiving services • No followup after discharge or if consumer is lost to contact for 90 days or more What Can TRAC Do for You? Reports: – Enrollment and reassessment rates – NOMs Outcome Report – Cross Tabs and Frequencies Data download: – Grantees can download data through CMHS-TRAC system and run analysis How Can Grantees Prepare? • Visit the TRAC Web site for more information at https://www.samhsa-gpra.samhsa.gov/home/ index.htm (Click CMHS TRAC General Information Service Programs Related Links ) • Contact TRAC Help Desk with your questions at 888-219-0238 or [email protected] • If necessary, seek IRB approval immediately • Determine processes for data collection Q&A