COSP QUALITATIVE STUDIES MAINE – Ruth Ralph
Maine’s Qualitative Plan addressed plans and the results
from both the COSP and the TMHS. They
looked at different aspects of the program activities, physical and social
environment, the changes needed, and the things that need to be added.
They have interviewed and shadowed both staff and clients at the Portland
Coalition. Ruth Ralph presented a summary of the COSP interviews: clients felt
they were in a safe, accepting environment that offered hope, opportunities and
information through support and resources.
Consumers liked the idea that they could drop-in at the center and that
it was available when they needed it. When asked, clients suggested the
following changes: bigger space, more meals, more funding, more staff, more
accountability from the board, and more programming.
Ideas from both case managers and clients: better match of the client and
case manager, increased money, reduction of paperwork, availability, and
reliability of case managers (case managers not available after hours).
Tom Summerfelt announced that that there is a small glitch
in the tracking database. If you
plan to use a 10 digit ID number for participants, as it is right now you can’t
go over two million four hundred thousand.
So you will be exceeding the 2,400,000 figure talk to Tom and he can help
you.
Pennsylvania – Mark Salzer
Pennsylvania’s did an in-depth focus and systemic review
of reasons why people seek positions in peer support providers.
Reasons for entering COSPs are to help others, but as you help other
people you secondarily benefit yourself as well. They interviewed sixteen women
and eight men at the 14 support connections.
Procedure: questions were asked about why respondents applied to the
Center as a peer-support specialist, what they liked about being a peer- support
specialist, and how they benefit from the position.
Interviews were taped and transcribed.
Analysis: Validity/Authenticity was coded to reflect the range of
experiences people have. Data was
broken down into program characteristics that attracted them to apply to Friends
Connection. Some reasons given were: to help respondents learn skills to survive
in the community, provide support after hospitalization, staff care of helping
the consumer, and to provide positive support to the community.
Job related reasons: not stuck in an office or institution, being able to
work with people instead of administration, and additional income.
Recovery orientated reasons: helping others, giving back to others,
personal satisfaction, and expanding their own social network.
Personal growth: learning or experiencing new things, chance to see if
person really wants to be a counselor.
Things that specialists like about being there:
facilitating others recovery and it is rewarding to watch others recover.
In organizations that use the 12 steps module, talking about personal
problems is helpful in a person’s own recovery.
Benefits cited were: development of leisure skills and abilities,
learning to behave responsibility, professional growth, independence,
responsibility, empowerment, flexibility, “allowed to be me,” and the
interactions with others.
Conclusions: Peer Support Specialists listed the following
reasons for their involvement: challenging work, money, benefits.
Staff wanted to emphasis that their personal benefits are low on the
scale – their primary focus is on the people in the program.
Primary conclusion: Consumer benefits are real aspects and need to be
counted as a benefit of the program.
MISSOURI – Brian McCorkle
The Missouri Qualitative study will be conducted at the
Empowerment Center. It will be lead
by Russell Schutz , chair of the Sociology Department at the University of
Boston. Interviewing will begin
next Spring or next Fall. The study
will be looking at who is going, why they are going, and what impact the Center
has had upon their lives.
TENNESSEE – Tom Summerfelt
The Tennessee Qualitative study
used multi approaches. Key
informant interviews were conducted with former BRIDGES students, support group
attendees, teachers, facilitators, administrators, and program staff.
Findings and products from BRIDGES interviews resulted in the testimonial
book sent to the sites. Sita Diehl
was the editor of the book. Tennessee
has tried to capture the program philosophy, the mission statement, services,
reporting information collected, where funding comes from and how it is used,
etc. In Consumer involvement opportunities we collected job
descriptions. In the first level of
ethnology there was the teacher training, the startup and the actual execution
of the class and class graduation. They
looked at two classes – one graduated, one dissolved before completion.
Conclusions: The BRIDGES
program has met challenges while working with consumer staff spread over 7
regions, or 85 counties. One of the
tenants of the program is that you take care of yourself first, but great
emphasis and value is placed on helping others.
Staff is cross-trained to step in when needed.
Some problems identified: inadequate staffing, morale, and communication
issues due to the 85 plus counties BRIDGES serves.
FLORIDA - Nancy Erwin
Nancy Erwin reported that Dr. Rich Valarie is responsible
for the FliCA Qualitative Research. Both
FL and CA will be doing the same thing. Both the Peer Center and Henderson
interviewed one focus group of members, one focus group of line staff, and six
individuals from the management and executive staff.
A coding system is being developed out of the transcribed data.
Dr. Valarie will have an interrater reliability protocol by the end of
the year. The analysis of qualitative data will be triangulated to verify:
Compare clients with managers, and compare use of different approaches (in the
case of the flow diagrams, developed through the staff vs. the descriptions of
how clients walk through it).
Illinois - Pat Corrigan
A three part data collection strategy used qualitative
techniques to understand the processes and outcomes associated with GROW.
Seventy-five GROW leaders and seventy-five GROW members were interviewed.
Analysis procedures included: 1) scanning the “blue book” into a coding and
storage software program for summarization qualitative, graphic strategies to
make certain GROW language is the same language used by consumers, 2) concerns
about the reliability of different groups of people being able to interpret the
codes led to analysis of the thirteen intervention themes that were identified
as being at the heart of the GROW program.
Part two of the analysis contains the testimony of 22 GROW
members. The codes were scanned to
determine how the intervention themes showed up in the testimonials.
GROW distinguishes the way up from the way down (descriptive of the
troubles an individual has had in life). The thirteen themes were coded to
define the thirteen way downs as the negative side of the thirteen way ups
(hopelessness and helplessness vs. the positive use of the themes).
Coordinating Center
Jean Campbell announced that in the F2F packets there is a
Qualitative Multi Site Study Proposal Draft that contains two proposals, the
first by Karen Hirsch and the second by Brian McCorkle.
Brian and Jean are in the process of melding these two together to form a
joint cooperative Qualitative Study with Boston University with Brian heading
that up along with the staff at MIMH, and Karen Hirsch.
The question Karen and Jean looked at was how the participating groups in
the COSP multisite study have developed their working relationships, and what
impacts these working relationships have had, and will continue to have on the
short term and long term outcomes of the COSP.
Jean explained that SAMHSA and other government-funded
projects are emphasizing the development of partnerships, rather than “solo”
efforts. A second goal was to look
at the partnerships that developed during this research. Karen and Jean thought qualitative research was the best way
to address that question. They thought it would be a real contribution to the
literature because some of these working relationships that are unique in our
project are really groundbreaking, according to Jean. The questions to be answered are, Can the COS and TMH work
together? Can consumers and
researchers work together? How will those working relationships develop?
The SC wanted a more
traditional qualitative type study that could address these issues, rather than
the pioneer dialogue approach. Some
of the broad characteristics of the draft Karen and Jean wrote were based on the
work of Michael Winer and Karen Ray for a Minnesota Foundation. They characterized working relationships as being based on
collaboration, cooperation, or coordination.
The focus is on the intensity of the partnership, how much risk is
involved, and how many resources (time and money) are shared among the group.
Jean and Karen will borrow from the “Collaborative Experience Questionnaire”
used by Winer and Ray to evaluative collaborative efforts.
Karen has developed a matrix to
identify the types of roles, and of all of the working relationships that have
gone on in this study. The SC will
be asked to rank the most important relationships. Members will be asked to
identify and nominate key participants to become interviewees for these
relationships. There will be two
rounds of interviews. The first
round will focus on the experiences prior to, and early in the study.
The second round will explore later experiences to see changes and
expectations for the future, beyond the study.
There will be no evaluation of
these relationships. They will be
descriptive, not prescriptive in nature. They
will be categorized analytically. Factors
expected to be crucial elements in describing the quality of partnerships are
ideology, leadership, power, history, competition, and shared resources.
Brian McCorkle explained that
the CC’s focus is on what happens between people. His interest is in what affect the study has on people, and
how people change over the course of the study through their collaboration with
a study that’s never been done before. He
pointed out that one-half of the PIs are consumers, and when you add their votes
to the CAP votes it means that three quarters of the decision-making votes are
actually by consumers.
In reviewing the GFA the first
goal is outcome in the COSP study, the second is to create strong and productive
relationships, the third is to disseminate the knowledge.
Brian emphasized that it was important to find enough material for
professional audiences that it encourages them to involve consumers, and to
provide material for consumers that would encourage them to participate in the
research. Focus areas would be on
the advantages and disadvantages of involvement so that people might be able to
make an informed choice.
The first round of interviews
involves everyone willing to participatein a 60-90 minute interview.
A round of analyses around the theory would be completed to find out what
themes were emerging. If necessary, a second round would be scheduled based on the
questions that emerged from the first round.
Brian M. reminded the group
that all of the project records go into the archives, and then become a matter
of public record. Even though the
interviewees’ names have been removed, someone looking at the data might be
able to figure out the identity of a person because the COSP is a small multi
site community. He assured the
group that steps would be taken to preserve confidentially. Some concerns were
voiced about what confidentiality issues might arise if the study results are
published. Brian indicated that in
any qualitative study any quotes used must be reviewed and approved by the
author of the quote.
Brian M. said that one of the
details to be worked out is the issue of reimbursement for participation. Other
details include: Who should conduct the interviews? How should interviews be done? By phone, or in person?
Jean Campbell reiterated that
neither one of these proposals is clearly defined at this point.
Concrete Specific Solutions
Brian McCorkle. thought sites should go ahead and change their
recruitment strategy. He pointed
out that the multi-site strategy hasn’t changed, but the demographics have.
Matt Johnsen said ideas and solutions are site-specific. A better idea
would be for each SC member to fill out one of the Concrete Specific Solutions.
Yvette Sangster stated that randomization is causing lots
of problems for CT, especially the drop-in centers. Betsy McDonel Herr
reinforced that there will be no relaxation of randomization within the next 3
months. If sites cannot randomize
the Federal team will discuss it internally, and get back to the site(s) to
discuss alternatives. Betsy stressed that the Federal team needs to collect
different data and co- variants. She
added that this study was not designed to go from randomization to
non-randomization.
Susan Essock and Pat Corrigan asked the SC members to
identify what part of the study might be hurting them now.
Louetta said the transportation issue is still a problem for TN.
One solution would be a grant, but they would need the study to be
extended for a year in order to take advantage of the grant.
Pat shared Crystal Blyler’s information that the Federal
Representatives, SAMHSA, and CMHS are considering a year extension on the study.
Pat announced that in trying to promote communications, a
scheduled time for teleconferences has been included in the F2Fpackets. The
Friday, Nov. 10 date was scratched, and Friday, March 30, 2001was added to the
schedule. The SC was asked to
review and abide by the SC Teleconference Guidelines located on the back of the
schedule. No cell phones will be
allowed, and only two connections are allowed per site due to the 19-person
limit imposed by the Sprint Teleconferencing System.
Sally Rogers made a
motion to move the teleconferences from Fridays to Thursdays.
Sally Clay seconded the motion. After
some discussion: Sally Rogers withdrew motion. Teleconferences will remain on Fridays.
Pat Corrigan brought up a proposal that the Research, COSP,
CAP, and Logistics Subcommittees hold F2F meetings in St. Louis.
There were objections to the St. Louis locale. Pat said Chairs who wanted
to propose meetings should send an agenda to the CC and talk to Jean Campbell
about a meeting place.
Pat announced that the Qualitative Committee would meet and
make a proposal. Jean is Chair, and
she will list the October 12th timeline on the listserv.
Subcommittee Reports
Research Subcommittee – Greg Teague
A commitment was made to stay
the course on research design but ways will be considered to maximize the gains
from the study. They will look at enhancements of current practices within the
study, make plans for optimizing scientific benefits from the data collected,
and evaluate design alterations. The
committee will seek outside consultation on statistical analysis and design
issues.
A motion was made by
Susan Essock that the Committee seek consultation from more than one outside
statistical consultant as to design and analytic strategies should current
trends in recruitment and retention continue. Seconded by Sally Rogers.
Passed unanimously.
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