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December 12, 1998 Steering Committee Meeting Notes
Steering Committee Meeting Minutes December 12, 1998 8:30 a.m. – 12:30 p.m. Embassy Suites Reports from Subcommittees Multi-Site Research Committee - Tom Salzer, chair Tasks of Research Committee -Generation of research questions -Check domains with hypotheses -Include any domains not considered in GFA but central in research questions
-Directed to consumer respondents -Identification of areas of measurements (domains) -Generation and evaluation of existing instruments >Consideration of Canadian protocol >Poll other multi-site projects regarding instruments -Selection of instrumentation/Newman & Ciarlo criteria >Appropriateness of tool for persons in the study (target population) >Reliability Interrater (will two people using it get the same results) Test-retest (stability over short periods of time) >Validity >Sensitivity to change >Reactivity >Cultural competence/sensitivity >Time estimate >Cost/effort/burden to respondent >Clarity >Consumer involvement in development -Design issues affecting cross-site protocol
-Pilot testing procedures -Informed consent, confidentiality, language, reasonableness of procedures -Consumers as interviewers and assessors -Access to data and publication policies -Inclusion/exclusion criteria -Split interview procedure -Data Collection Timetable -Cross-site comparability/comparison -Setting deliverables -Development of training manual
-Role of sites in cross-site fidelity assessment -Pilot testing of cross-site instrument
Brainstorming of Outcome Domains
-Recovery
-Symptoms -Diagnosis -Medications -Years in System -Number of hospitalizations -Distress level -Stress factor, indicators – situational (acute), chronic
Subcommittees The following subcommittees were established. Their work is to be completed over next couple of weeks (12/21/98) via teleconferences. Theoretical framework/logic model for cross-site study Mark Salzer, Chair Empowerment Steve Segal/Carol Silversman, Chairs Housing Fred Newman, Chair Employment/demographics/substance Use Pat Corrigan, Char Satisfaction with services Matt Johnsen, Char Social inclusion Joseph Rogers, Chair The qualitative data needs to be included. Cost Study Committee – Dr. Brian Yates Reporting There are two to three types of variables in cost study, many of which are not costs
Cost savings benefits such as use of other services may increase at first but may eventually decrease. Some of the direct benefits identified by the committee were training and services returned to the community (provided by clients). Cost measurement issues
The issues: the cost of cost assessment (sites did not budget for it) and there are costs to sites and to the consumers. These are things that the committee looked at (benefit)
Next Steps for Committee
Consumer Advisory Panel There were about 15 people in meeting ranging from users of services to consumer professionals. Many sites have not yet formed local consumer advisory panels. The committee looked at what is committee charge and the constitution of its membership. There was agreement that consumers' perspectives should be represented on the other two committees, but that time still needs to be set aside for the consumers to meet separately. The membership – all consumers who attended Steering Committee would be eligible to attend. There was some discussion about who is a consumer. It was decided that researchers who are consumers are consumers. At some point need to stop squabbling about who are consumers. The consumer voter is supposed to be appointed by the local consumer advisory panel. Consumer representation is needed on two levels -- (1) one of the people being assessed, and (2) people who can understand and represent the larger consumer viewpoint. The person should be named by consumer advisory committees locally but need not be current consumer. Each site will decide who will serve as its designated voter. The charge of the committee is to train consumers who come to these meetings in the language of research and other necessary meeting. At the next meeting, there will be a research 101 segment presented for consumers. Mutual support is another charge of the committee. The third charge is to advocate the consumer viewpoint in larger committees, and the fourth is to represent the viewpoint of people who will be assessed. The meetings will be ad hoc so that consumers can continue to participate in working committees. Next Steps for Steering Committee Each subcommittee of the Multi-Site Research Committee needs to have copies of all of the instruments used by each site. Dr. Campbell asked that each member contact Dr. Paul Binner at the Coordinating Center by Wednesday to let him know which instruments are needed so they can be in the hands of the subcommittees by next week. Mr. McKinnon will set up teleconferences initially through SAMHSA. Common Protocol Timeline (Due in March)
There will be a face-to-face meeting by January 31 through February 2, 1999. There will be a draft protocol by the meeting. The final responsibility for pulling together the draft instrument will rest with the Coordinating Center and Tom Salzer. It will be distributed by the Coordinating Center to the Steering Committee prior the meeting. This draft will focus on five domains. Work will still need to be done on procedures, cost pieces, etc. For costs, some of the instruments may already be out there. Cost procedures will be developed. There needs to be two face-to-face meetings before the end of March. Mr. McKinnon said it is nice to have domains, but unless folks are able to define what they are doing in their studies, we won’t know. We are taking measures first without thinking about what it is we are going to be measuring. Dr. Johnsen said the fidelity measurement would be developed in Year 2. While the subcommittees are working, ROW will document services and figure out a way to do the fidelity assessment. The Coordinating Center will begin to define what the services are. Perhaps an ethnographer can go to each site and document the services at each site. Dr. Campbell said site visits were going to be scheduled, but not in next week or two weeks. We need common understanding of empowerment, social inclusion, etc. Mark Salzer will develop a logic model to describe the activities, hypotheses, and outcomes. Part of the discussion for next face-to-face meeting is the logic model. Dr. Campbell said the Coordinating Center will develop a chart to describe which services the Coordinating Center can help sites with and which services that sites will have to do on their own. Next Meeting The next meeting will be in the Washington, D.C. area and begin Sunday, January 31 in the afternoon and end Tuesday, February 2 by early afternoon. The subcommittees might come in Saturday to meet or meet on Tuesday evening. The first half of the general meeting will allow time for the committees to work. Tentative Agenda
Minutes of this first meeting will be posted on the web site by the last week in December and will be sent out to everyone by the Coordinating Center. A glossary of terms is being developed by the Coordinating Center. The subcommittees will work on definitions of peer support, etc. Feedback Session
Mr. Brown thanked everyone for participating in the meeting. This is historic and not only was it a successful meeting, but was very productive in comparison to other multi-site projects. All of the discourse was positive, and it was a credit to the people who planned the meeting and participated. This overwhelming feeling happens to all of the groups. Dr. Ralph recognized Dr. Campbell for her work. December 9, 1998 Meeting
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