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How do measures measure up?

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Page 1: How do measures measure up?. What is the Centre? Knowledge Bringing people and knowledge together to promote the best mental health and well-being for

How do measures measure up?

Page 2: How do measures measure up?. What is the Centre? Knowledge Bringing people and knowledge together to promote the best mental health and well-being for

What is the Centre?What is the Centre?

Knowledge

Bringing people and knowledge together to promote the best mental health and

well-being for every child and youth

Capacity Partnerships

Full continuum of effective and accessible mental health services for children and youth.

Page 3: How do measures measure up?. What is the Centre? Knowledge Bringing people and knowledge together to promote the best mental health and well-being for

Brief IntroductionsBrief Introductions

Name and affiliation Program to be evaluated One outcome of interest

Page 4: How do measures measure up?. What is the Centre? Knowledge Bringing people and knowledge together to promote the best mental health and well-being for

ObjectivesObjectives

To provide an overview of concepts on measurement

To provide guidelines for assessing and selecting measures

To reduce fear on the topic of measures and indicators

Page 5: How do measures measure up?. What is the Centre? Knowledge Bringing people and knowledge together to promote the best mental health and well-being for

OutlineOutline

A. What is measurement?

B. What are the different sources of data and types of measures?

C. What affects the quality of measures?

D. How can we select appropriate measures for our evaluation?

Page 6: How do measures measure up?. What is the Centre? Knowledge Bringing people and knowledge together to promote the best mental health and well-being for

A. What is measurement?A. What is measurement?

Page 7: How do measures measure up?. What is the Centre? Knowledge Bringing people and knowledge together to promote the best mental health and well-being for

Getting Ready for Getting Ready for EvaluationEvaluation

Evaluation Heaven!

Evaluation Heaven!

Develop Logic Model

Identify Priority Outcomes

Review and Select Measures

Develop Data CollectionProcedures

Page 8: How do measures measure up?. What is the Centre? Knowledge Bringing people and knowledge together to promote the best mental health and well-being for

What is measurement?What is measurement?

Measurement refers to the process of “operationalizing” the evaluation question

Evaluation question

Information needed

Sources of information

Types of data

Evaluation Measure

Page 9: How do measures measure up?. What is the Centre? Knowledge Bringing people and knowledge together to promote the best mental health and well-being for

Sample Evaluation Question: What are clients’

perceptions of our services? Has client satisfaction with

our services improved? What areas of the program

do we need to improve on?

Evaluation question

Information needed

Sources of information

Types of data

Evaluation Measure

Page 10: How do measures measure up?. What is the Centre? Knowledge Bringing people and knowledge together to promote the best mental health and well-being for

Information from parents and/or youth on:

Satisfaction with location Ease in accessing the services Perceptions of outcomes as a

result of the service Appropriateness of the

services Perceptions on therapeutic

alliance or relationship

Evaluation question

Information needed

Sources of information

Types of data

Evaluation Measure

Page 11: How do measures measure up?. What is the Centre? Knowledge Bringing people and knowledge together to promote the best mental health and well-being for

B. What are the different B. What are the different sources of data and sources of data and types of measures?types of measures?

Page 12: How do measures measure up?. What is the Centre? Knowledge Bringing people and knowledge together to promote the best mental health and well-being for

Levels of measurementLevels of measurement

Nominal Ordinal Interval Ratio

Page 13: How do measures measure up?. What is the Centre? Knowledge Bringing people and knowledge together to promote the best mental health and well-being for

Sources of informationSources of information Questionnaires Interviews or focus groups Observation Administrative data and/or Health records

Page 14: How do measures measure up?. What is the Centre? Knowledge Bringing people and knowledge together to promote the best mental health and well-being for

Sources of information from parents and/or youth on how they experience our services:

Interview Focus groups Administrative data: number and

type of complaints Self-administered survey Standardized questionnaire

Evaluation question

Information needed

Sources of information

Types of data

Evaluation Measure

Page 15: How do measures measure up?. What is the Centre? Knowledge Bringing people and knowledge together to promote the best mental health and well-being for

Qualitative data: verbal and pictorial Numeric scores:

• Basic units such as frequency, duration, length• Scores from rating scales• Standardized scores (z scores)• Age- or grade-equivalent or adjusted scores

Criteria for evaluating scores:• Standardization: procedural comparability• Psychometric properties

Types of DataTypes of Data

Page 16: How do measures measure up?. What is the Centre? Knowledge Bringing people and knowledge together to promote the best mental health and well-being for

Type of data on clients’ satisfaction or perception of care

Scores on a standardized measure on client perception of care: • Average of ratings on all

items• Changes in average ratings

every 6 months

Evaluation question

Information needed

Sources of information

Types of data

Evaluation Measure

Page 17: How do measures measure up?. What is the Centre? Knowledge Bringing people and knowledge together to promote the best mental health and well-being for

C. What affects the quality C. What affects the quality of measures?of measures?

Page 18: How do measures measure up?. What is the Centre? Knowledge Bringing people and knowledge together to promote the best mental health and well-being for

Cultural and Historical ContextCultural and Historical Context Use of tests and measures as a

“cultural tool” Cultural appropriateness of the

measures Revisions or updates to

measures to accommodate changes in scores in the population

Page 19: How do measures measure up?. What is the Centre? Knowledge Bringing people and knowledge together to promote the best mental health and well-being for

Psychometric Properties: ValidityPsychometric Properties: Validity

Does the measure REALLY measure what it is supposed to measure?

Face validity

Content Validity

Construct, Construct, Criterion Criterion

and and FactorialFactorial

PredictiveConcurrent

Discriminant or Divergent

Page 20: How do measures measure up?. What is the Centre? Knowledge Bringing people and knowledge together to promote the best mental health and well-being for

Psychometric Properties: ReliabilityPsychometric Properties: Reliability

= Dependable

= Trustworthy

= Same old, Same old

Page 21: How do measures measure up?. What is the Centre? Knowledge Bringing people and knowledge together to promote the best mental health and well-being for

Cost and availability Time for administering, scoring

and analyzing Staff involvement Information management

Psychometric Properties: FeasibilityPsychometric Properties: Feasibility

Page 22: How do measures measure up?. What is the Centre? Knowledge Bringing people and knowledge together to promote the best mental health and well-being for

Clinical utility Culturally appropriate Administrative uses for decision-making Usefulness for improving program Usefulness for information on public reports

Psychometric Properties: Psychometric Properties: RelevanceRelevance

Page 23: How do measures measure up?. What is the Centre? Knowledge Bringing people and knowledge together to promote the best mental health and well-being for

Other measurement considerations Other measurement considerations when involving childrenwhen involving children

Developmental level Educational level Health status Family

Page 24: How do measures measure up?. What is the Centre? Knowledge Bringing people and knowledge together to promote the best mental health and well-being for

D. How can we select D. How can we select appropriate measures for appropriate measures for

our evaluation?our evaluation?

Page 25: How do measures measure up?. What is the Centre? Knowledge Bringing people and knowledge together to promote the best mental health and well-being for

Criteria for selecting measuresCriteria for selecting measures

Evidence-based

Feasible

Relevant and meaningful

Page 26: How do measures measure up?. What is the Centre? Knowledge Bringing people and knowledge together to promote the best mental health and well-being for

Evidence-basedEvidence-based

Sound psychometric properties: valid and reliable

Used in similar settings Recommended by experts, if no previous

literature

Page 27: How do measures measure up?. What is the Centre? Knowledge Bringing people and knowledge together to promote the best mental health and well-being for

Sample Summary TablesSample Summary Tables

Page 28: How do measures measure up?. What is the Centre? Knowledge Bringing people and knowledge together to promote the best mental health and well-being for

Sample Summary TableSample Summary Table

Name of Measure

Reference or Developer

Areas measured

Evidence on reliability and validity

Feasibility

(cost, training, who administers)

Relevance Comments

Page 29: How do measures measure up?. What is the Centre? Knowledge Bringing people and knowledge together to promote the best mental health and well-being for
Page 30: How do measures measure up?. What is the Centre? Knowledge Bringing people and knowledge together to promote the best mental health and well-being for

Evaluation question

Information needed

Sources of information

Types of data

Evaluation Measure

General Information

Developer/ Authors Children’s Indicator Workgroup of Sixteen State Study, Centre for Mental Health Services.

Date of publication, versions available

2001.Separate forms for parents and youth.

Constructs measured The YSS is used as a measure of youth service usage and satisfaction with services.The YSSF is used as a measure of parent report of youth service usage and satisfaction with services.

Population for which designed

Adolescents ages 13 and up.

Method of administration

Self-report questionnaire, paper or telephone interview.

Subscales and number of items

25 items.Five scores based on a factor analysis can be obtained:Good access to servicesParticipation in treatmentCultural sensitivity of staffAppropriateness of servicesPositive outcome of service

Estimated time to administer

Not mentioned.

Costs, availability and permission to use

In public domain. See online resources below.

Examiner qualifications and training requirements

Information not available at this time.

Youth Services Surveys (YSS, YSSF)

Page 31: How do measures measure up?. What is the Centre? Knowledge Bringing people and knowledge together to promote the best mental health and well-being for

Technical Information

Sample for development of norms

The YSS was created as part of the Mental health Statistics Improvement Program for the Sixteen State Study.

To date 430 youth have completed the survey.

Reliability Reliability indices for the 5 factors of the survey are good: Access = .713, Participation in Treatment = .776, Cultural Sensitivity = .863, Appropriateness = .863, Outcome =.893 (Brunk et al 2000)

Validity This indicator was developed by the U.S. Substance Abuse and Mental Health Services Administration (SAMHSA) for the National Mental Health Performance Measures, and feasibility was assessed across 16 states (Lutterman et al, 2003). The Virginia Department of Mental Health, Mental Retardation, and Substance Abuse Services coordinated the development of the surveys for children and youth (Brunk et al 2000).

The survey is widely used in the U.S. and reports by various states are available in the grey literature.

Uses The YSS may be used for the following:(1) As a data collection method for the following: Client perception of care, consumers

linked to physical health services, children in family-like arrangements and other 24-hour residential care programs.

(2) As a clarification method for findings from other indicators.(3) As a measure of penetration (when providers serve a higher than average

percentage of youth with a particular problem than occurs in the general population.

Review and Comments

Applicability for Ontario

Information not available at this time.

Other considerations

Information not available at this time.

Resources

Key References Brunk, M. (2001). Youth Services surveys Guidelines for administration. [Power Point presentation].

Brunk, M., Koch, J.R., McCall, B. (2002). Report on Parent satisfaction with Services at Community Services Boards. Virginia Department of Mental Health, Mental Retardation and Substance Abuse Services.

Online Resources http://www.mhsip.org

Contact information

E-mail : [email protected].

Youth Services Surveys (YSS, YSSF) http://www.mhsip.org

Page 32: How do measures measure up?. What is the Centre? Knowledge Bringing people and knowledge together to promote the best mental health and well-being for

Evaluation question

Information needed

Sources of information

Types of data

Evaluation Measure

Measures of Therapeutic Alliance

Blatt & Zuroff 2005: Importance of including therapeutic alliance as a factor moderating treatment outcomes science direct link

Elvins & Green 2008: Review of concept and measures on therapeutic alliance science direct link2

Green 2006: Measures on therapeutic alliance for child and youth mental health interscience link

Blatt & Zuroff 2005: Importance of including therapeutic alliance as a factor moderating treatment outcomes science direct link

Elvins & Green 2008: Review of concept and measures on therapeutic alliance science direct link2

Green 2006: Measures on therapeutic alliance for child and youth mental health interscience link

Page 33: How do measures measure up?. What is the Centre? Knowledge Bringing people and knowledge together to promote the best mental health and well-being for

Evaluation question

Information needed

Sources of information

Types of data

Evaluation Measure

Measures on Cultural Competency

Cultural Competency Self-Evaluation Questionnaire friends link

Page 34: How do measures measure up?. What is the Centre? Knowledge Bringing people and knowledge together to promote the best mental health and well-being for

Some common issuesSome common issues

To translate or not Picking and choosing items from various

measures Making sense of data: indicators,

benchmarks and standards

Page 35: How do measures measure up?. What is the Centre? Knowledge Bringing people and knowledge together to promote the best mental health and well-being for

Decision process for identifying, Decision process for identifying, selecting and using measuresselecting and using measures

Specifytopic

of inquiry

Identifying Selecting Using

Conductliterature

review

Identifyexisting

measures

IdentifyGap:

NO existingmeasures

Examine evidence,

feasibility &relevance

Usemeasure

Revisemeasure

Developnew

measure

Collect &AnalyzeData (as

Developed)

Gather newevidence onvalidity andreliability

Page 36: How do measures measure up?. What is the Centre? Knowledge Bringing people and knowledge together to promote the best mental health and well-being for

Steps in Translating MeasuresSteps in Translating Measures

Translateto secondlanguage

Back translate

to firstlanguage

Pilot-testwith

experts &end-users

Gather newevidence

on validityand reliability

Compareresults with

originalversion

Page 37: How do measures measure up?. What is the Centre? Knowledge Bringing people and knowledge together to promote the best mental health and well-being for

Measures MatrixMeasures Matrix Evaluation question Outcome or process variable Indicator or measure Where data comes from How data is collected data & how frequently Who collects data When data is collected How data will be analyzed

Page 38: How do measures measure up?. What is the Centre? Knowledge Bringing people and knowledge together to promote the best mental health and well-being for

Sample Measures MatrixSample Measures MatrixEvaluation question Do clients perceive outcomes as a result of the

care/ services they receive?

Process or Outcome variable

Client perception of care

Indicator/ Measure Youth Services Survey

Source of data Youth 16 to 18 years, and

Parents of children and youth below 16 years

How data is collected Self-administered questionnaire, in-person and by mail

Who collects data Receptionist

When data is collected At termination of the program, at least 3 months in program

Plan for analysis Compare means of total scores for those in Program A with those in Program B

Page 39: How do measures measure up?. What is the Centre? Knowledge Bringing people and knowledge together to promote the best mental health and well-being for

Questions?Questions?

Key insights?Key insights?

Page 40: How do measures measure up?. What is the Centre? Knowledge Bringing people and knowledge together to promote the best mental health and well-being for

SummarySummary

Measurement involves specifying or “operationalizing” the evaluation question.

Process or outcome variables can be assessed using numerical or qualitative data.

Sources of information include questionnaires, interviews, focused groups and administrative data.

Page 41: How do measures measure up?. What is the Centre? Knowledge Bringing people and knowledge together to promote the best mental health and well-being for

Summary, Cont. Summary, Cont.

Summary tables assist in organizing information about various measures, and help in making informed decisions on the most appropriate measure for the evaluation.

A matrix of the indicators and measures to be used in the evaluation summarizes how, where and when data is to be collected.

Page 42: How do measures measure up?. What is the Centre? Knowledge Bringing people and knowledge together to promote the best mental health and well-being for

Next StepsNext Steps

Review logic model and identify evaluation questions

Specify process and outcome variables Summarize literature review Review and select measures Create indicators and measures matrix Develop protocol for collecting data Develop plan for analyzing data

Page 43: How do measures measure up?. What is the Centre? Knowledge Bringing people and knowledge together to promote the best mental health and well-being for

Future webinars?Future webinars?

February 2009: Using Excel and SPSS for basic statistics

March 2009: Writing the Final Report

Page 44: How do measures measure up?. What is the Centre? Knowledge Bringing people and knowledge together to promote the best mental health and well-being for

For more informationFor more information

Evangeline Danseco, PhDHead, Evaluation and Research

[email protected], ext. 3319

www.onthepoint.ca