Implementation, Fidelity, and Outcomes Following Novel and Usual Critical Time Intervention Training

NCT02427022 | Completed Phase 2

• 1 other identifier: HHSN-271-2010-00032-C
• Study Type: interventional
• Target: 179
• Locations: 1 country
• Sites: 1

Brief Summary

Clinical social workers and other staff providing direct care to individuals experiencing homelessness face multiple challenges in obtaining training and implementing evidence-based practices in diverse community settings. Critical Time Intervention (CTI) is an increasingly popular evidence based practice with these agencies. With funding from a Phase II Small Business Innovation Research grant from the National Institute of Mental Health, the Center for Social Innovation developed an online multi-media training on CTI which incorporates a Community of Practice approach to encourage peer-based learning. The primary aim of this longitudinal, randomized-control study is to compare and contrast this online training modality with a face-to-face training on implementation of and fidelity to the CTI model over time. Nearly two-hundred direct service providers from 20 homeless-service agencies were randomly assigned to complete either an online or face-to-face training in CTI. Pre-post training and knowledge-retention surveys, interviews with trainers, agency administrators, and providers were conducted to track satisfaction with the training and experiences in implementing CTI. CTI-specific chart forms are used to assess fidelity to the CTI model, and administrative data from the agencies capture client-level outcomes.

Conditions

Homeless Services; Human Services Training

Keywords

evidence based practices, critical time intervention

Outcome Measures

Primary Outcomes (1)

• Change in confidence in CTI principles [attitudinal]

  Providers were asked to rate their confidence using a 5-point scale (1=not at all confident; 2=not really confident; 3=somewhat confident; 4=confident; 5=extremely confident) in eight key areas: 1) describing CTI as an intervention and its core principles; 2) describing who is on a CTI team and their roles; 3) describing the clinical treatment areas involved with CTI principles; 4) describing the five core skills of CTI and their purposes; 5) describing how to start a CTI program including identifying client and community needs; 6) identifying some of the challenges that might arise in trying to establish CTI in different settings; 7) how chart work differs from CTI work; and 8) describing the key indicators that CTi is implementing. Providers in both treatments were asked to complete these questions in both pre and post surveys.

  Pre and post surveys (June and July, 2011; weeks 1 and 2)

Secondary Outcomes (6)

• Training format preference [attitudinal]

  Prior to intervention (June, 2011; week 1)

• Participant satisfaction [attitudinal]

  Post interventions (July, 2011; week 2)

• Participant satisfaction [attitudinal]

  Post intervention (March 2012; week 2)

• Confidence in readiness to implement CTI principles [attitudinal]

  Post intervention (June 2011; week 2)

• Knowledge retention [knowledge]

  Pre, post and follow up surveys weeks post training and six months post training (June 2011 and December 2011; weeks 1, 2 and 24)

Study Arms (2)

Online CTI Training

EXPERIMENTAL

Services providers in this group received a novel online CTI training. The enhanced course combines depth of knowledge among trainers, skills-based and practical approaches to learning, new technologies, and opportunities for social networking. The course is divided the knowledge, skills, and tools associated with CTI into four two-week modules. The total instruction time for the course was 24 hours.

Other: CTI

Face-to-Face CTI Training

ACTIVE COMPARATOR

Service providers in the group received 1.5-days of face-to-face CTI training at each study site with one trainer. There were a total of 8 hours of instructor led training per site. Face-to-face training sessions were followed by three assignments with feedback from trainers, and eight 60-minute telephone consultation sessions.

Other: CTI

Interventions

CTI OTHER

CTI is an empirically supported, time-limited case management model designed to prevent homelessness and other adverse outcomes in people with mental illness following discharge from hospitals, shelters, prisons and other institutions. CTI was originally developed and tested by researchers and clinicians at Columbia University and New York State Psychiatric Institute with significant support from the National Institute of Mental Health and the New York State Office of Mental Health.

Face-to-Face CTI Training; Online CTI Training

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Possessing administrative-level support for implementing CTI within the agency
• Capability of engaging at least one CTI team in training
• Willingness to engage in evaluation
• A willingness to collect and share administrative client data

You may not qualify if:

• Not possessing administrative support
• Not capable of of engaging at least one CTI team in training
• Not willing to engage in evaluation
• Not willing to collect and share administrative client data
• Capacity to fill one of the three roles necessary for CTI team membership or eligibility to shift into those roles: Supervisor, Field Coordinator, or CTI Worker; and,
• Willingness to engage in the CTI training and the study activities.
• Individuals not working as a supervisor, field coordinator or CTI Worker within an eligible service organization.
• Individuals not willing to engage in CTI training and study activities.

Sponsors & Collaborators

• Center for Social Innovation, Massachusetts: lead
• Columbia University: collaborator
• Hunter College of City University of New York: collaborator

Study Sites (1)

Center for Social Innovation

Needham, Massachusetts, 02494, United States

Location

Related Publications (2)

• da Silva, T. F. C., Lovisi, G. M. & Conover, S. (2014) Developing an instrument for assessing fidelity to the intervention in the Critical Time Intervention - Task Shifting (CTI-TS): Preliminary report. Archives of Psychiatry and Psychotherapy, 1: 55-62.

  BACKGROUND

• Aarons GA. Mental health provider attitudes toward adoption of evidence-based practice: the Evidence-Based Practice Attitude Scale (EBPAS). Ment Health Serv Res. 2004 Jun;6(2):61-74. doi: 10.1023/b:mhsr.0000024351.12294.65.

  PMID: 15224451 BACKGROUND

Study Officials

• Jeffrey Olivet, MA

  Center for Social Innovation

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: phase 2
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: HEALTH SERVICES RESEARCH
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: July 10, 2014
• First Posted: April 27, 2015
• Study Start: September 1, 2010
• Primary Completion: October 1, 2012
• Study Completion: February 1, 2013
• Last Updated: April 27, 2015

Record last verified: 2014-07

Locations

US (1)