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11
Do you or don’t you?
Measuring Fidelity to Evidence-
Based Supervision
Dr. W. Carsten Andresen
Dr. Geraldine Nagy
Travis County Adult Probation
2011 APPA Summer Conference - Chicago, Illinois
Let’s go beyond the EBP sound bite…
Please use EBP today
That’s EBP !
EBP has plenty of dash…
Where is the evidence?
EBP has plenty of dash…
Please use EBP today
That’s EBP !
These are pretty pictures, but…
Overview: Supervision Fidelity
Training and Learning Objectives
Evidence-Based Practices model
Department Studies
― Officer Supervision (aka fidelity study)
― Residential Treatment study
Training and Learning Objectives
1. Define and identify examples of
supervision fidelity and client outcomes
2. Explain the relationship between
supervision fidelity and client outcomes
Training and Learning Objectives
3. Identify the dimensions of community
supervision that are important to
measure (fidelity study)
4. Describe methods of evaluating
supervision fidelity
Training and Learning Objectives
5. Discuss approaches to present
measures of supervision fidelity to the
general public
Moving beyond the sound
bite…What do prior studies tell us about EBP:
Objective One:
Define and identify examples of
supervision fidelity and client
outcomes.
Outcomes: eventual effects of a program on
some condition (Maxfield, 2001).
- Probation Violations
- Revocations
- New Arrests
Supervision fidelity is less studied
Fidelity: presence of EBP elements and
quality of implementation
- Assess actuarial risk-needs
- Motivational Interviewing
- Target Interventions
- Positive Reinforcement
- Engage ongoing community support
o Risk principle
o Need principle
o Responsivity
o Dosage
o Treatment
14
Most evaluations involve a leap of faith
Program
Evaluations focus solely on outcomes
Evaluations sidestep fidelity measures
Most studies only measure outcomes
What about supervision quality?
How can you measure if EBP is happening?
Can we measure supervision quality and outcomes?
Travis County Adult Probation: We
primarily had outcome evaluations
External Evaluators: strong outcomes
Our own data: strong outcomes
- Dr. Tony Fabelo,
Justice Center,
Council of State Government
Travis Steepest Decline in Felony Revocations
(Fabelo, 2009)
- 19.6%
Travis Lowest Revocation Rate Out of Population
(Fabelo, 2009)
9%
Travis Steepest Decline in Technical Revocations
(Fabelo, 2009)
- 47.7%
Travis Lowest Rate of Technical Revocations
(Fabelo, 2009)
3.4%
Reduced Felony Revocations
Revocations Technical Revocations
- 270
- 294
Reduced Felony Absconders
- 1,659
Reduction in New Felony Absconders
- 422
24
Do we successfully use EBP?
Effective
Program
Outcomes
due to other factors
Ou
tco
me
s
High
Low
Objective Two:
Explain the relationship between
supervision fidelity and client
outcomes
26
EBP Model: Outcomes
Effective
Program
Outcomes
due to other factors
Ou
tco
me
s
High
Low
What about our Supervision Fidelity?
27
EBP Model: Fidelity and Outcomes
Effective
Program
Ineffective
Program
Outcomes
due to other factors
Poorly
Implemented
Ou
tco
me
s
Fidelity
High
Low
Low High
Spring 2009: Study Supervision Fidelity
TCIS measured at beginning of implementation
Initial baseline identifies areas to improve
Unannounced “pop quiz” of TCIS fidelity
Future fidelity studies can track progress
But where should we begin?
Travis Community Impact Supervision
Measuring Fidelity TCIS
TCIS measured at beginning of implementation
Initial baseline identifies areas to improve
Unannounced “pop quiz” of TCIS fidelity
Future fidelity studies can track progress
EBP Process and Context
Measuring Fidelity to EBP
Measured at beginning of implementation
Initial baseline identifies areas to improve
Unannounced “pop quiz” of EBP fidelity
Future fidelity studies can track progress
Two Travis County Supervision Studies
Felony Cohort (Jan 2008 - Placements)
Follow supervision practices for six months
Focus on cases direct for at least three months
Follow up: Cohort (Jan 2009 - Placements)
Sample of Felony-reduced and Misdemeanants
Study Descriptives
2. Coders
Study 1
1. Cohort Sample
Study 2
- Felons 134 102 - Felony-Reduced 17- Misdemeanants 46
- Administrators X X - Operations-Research X X- Managers X
Objective Three:
Identity the dimensions of
community supervision that are
important to measure
(Fidelity study)
Purpose:
To measure our fidelity to EBP
Objective Four:
Describe methods of evaluating
supervision fidelity
36
Case File Review Form – Fidelity to EBP
37
Methodology
CSS Case File
Review
Form
Probationer
Case File
38
Methodology
Case File Review Form Database
Objective Five:
Discuss approaches to present
measures of supervision fidelity
to the general public
Fidelity Study:
Fidelity to EBP Results (Jan 2009)
Supervision Fidelity:
Do we create accurate assessments?
We have validated our risk assessment instrument
three times
We have conducted Inter-rater reliability tests on our
Diagnostic Report Process
Do we create accurate assessments?
89%
95%
95%
89%
We checked scoring on each diagnostic instrument
for each person
Supervision Fidelity:
What about the Judiciary / Courts?
44
Court-Ordered Conditions of Probation
90%
Supervision Fidelity:
What about Supervision Process?
46
Do we focus on risk-needs and use
motivational interviewing?
We examined each
point carefully.
47
Correct Caseload
- Maintenance Caseload
- Regular Caseload
- Correct Specialized
Caseload match Probationer?
97%
48
Supervision Agreement
85%
Note: Some felony probationers were excluded from
this analysis because they were unable to
create a Supervision Agreement for various
reasons (i.e. absconding, reoffending)
49
Supervision Agreement
85%
50
Responsivity / Motivation
51
Responsivity / Motivation
- 83% some use
- 53% frequent use
Source: High and Medium Risk Felons
We used a 5-point scale to measure
Motivational Interviewing
52
Sanctions / Incentives
67%
53
Sanctions / Incentives
67%
2009: 10 rush warrants
- all 10 addressed properly
- all 10 timely response
54
Sanctions / Incentives
75%
55
Overview of Internal Studies
56
EBP Model: Fidelity and Outcomes
Effective
Program
Ineffective
Program
Outcomes
due to other factors
Poorly
Implemented
Ou
tco
me
s
Fidelity
High
Low
Low High
57
EBP Model: Fidelity and Outcomes
Effective
Program
Ou
tco
me
s
Fidelity
High
Low
Low High
What about Fidelity Outcomes?
What happened to the probationers in this supervision study?
Felony probationers: two year follow-up
Revocations
Arrests
EBP Supervision appears correlated with better
outcomes for felony probationers, with caveats
Small felony sample
Difficult to account for complicated interactions
between variables
Overall Supervision Measure
- Was the Supervision Appropriate?
Data Source: Coder provided summary ranking of
supervision quality.
The Supervision Agreement is more
than just a piece of paper
We looked for evidence that this document played a role in the supervision process. We examined if the document had the following:
Probationer’s signature
Indications that the creation of the Supervision
Agreement was a collaborative process
Chronological Notes suggesting that the
Supervision Agreement was the foundation for
office visits
Did the Supervision Agreement show
signs of EBP
Yes: Signature, evidence of cooperation, evidence it
was used as the foundation for office visits
Now we will move
away from supervision
to discuss SMART –
our Residential Drug
Treatment Program.
Fidelity Evaluation: Drug Treatment
What does our SMART Program do?
Does it engage in Evidence-Based practices?
Quality of work?
64
EBP Model: Fidelity and Outcomes
Effective
Program
Ineffective
Program
Outcomes
due to other factors
Poorly
Implemented
Ou
tco
me
s
Fidelity
High
Low
Low High
65
Prior SMART Residential Analysis
• Corrections Institute-University of Cincinnati
– Correctional Program Checklist (CPC)
• Highly Effective
• Effective
• Needs Improvement
• Ineffective
CPC – 5 Domains
- Leadership
- Staff
-Assessment
-Treatment
-Quality Assurance
66
Corrections Institute – University of Cincinnati
SMART Program Rank (400+ Programs)
18% Effective
33% Needs Improvement
42% Ineffective
7% Highly Effective SMART Program
Shaffer, DK and C Thompson. (2008). Evidence-Based Correctional Program Checklist – SMART Program. University of Cincinnati.
67
Study: 3 yrs successful completions - 18 month follow-upSMARTSep 2005 - Aug 2008 18
2004
Sept
2005
Sept
2006
Sept
2007
Sept
2008
Sept
2009
Sept
Feb 2007
SOMP start
SMART Residential Program
Nov 2008: CPC
Comparison Group
18
1818Sep 2005 - Aug 2008
68
Creating Comparison Group
- Risk Score
- Fiscal Year
- Age Range
- Race-Ethnicity
- Gender
- Offense Degree
- Offense Type
Smart Comparison
N = 559 N = 489
•Individual cases matched on seven factors
• Many studies avoid risk / lack comparison groups
69
It is critical to match for Risk Score
9% 25% 67% - Felony Placements
0% 14% 86% - Smart
70
Note: this captures # of arrests, not # of people arrested.
All Arrest Categories (by group)
27 % fewer total arrests
12% fewer total felony arrests15 % fewer total misd arrests
SMART: % decrease in total arrests
71
EBP Model: Fidelity and Outcomes
Effective
Program
Ineffective
Program
Outcomes
due to other factors
Poorly
Implemented
Ou
tco
me
s
Fidelity
High
Low
Low High