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Developing a Resource Guide for CANS Data Analysis and Reporting

Developing a Resource Guide for CANS Data Analysis and Reporting. Vicki Sprague Effland, Ph.D. Youth Improved!. Youth Improved!. Did Youth Improve Enough?. Need for Resource Guide. Standardize methodology for CANS data analysis Establish benchmarks for various data analysis methods

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Developing a Resource Guide for CANS Data Analysis and Reporting

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  1. Developing a Resource Guide for CANS Data Analysis and Reporting Vicki Sprague Effland, Ph.D.

  2. Youth Improved!

  3. Youth Improved!

  4. Did Youth Improve Enough?

  5. Need for Resource Guide • Standardize methodology for CANS data analysis • Establish benchmarks for various data analysis methods • Develop guidelines for reporting CANS results

  6. Introduction to Choices

  7. Choices, Inc. • Non profit care management entity created in 1997 • Developed around a community need: “high cost youth” • Blended system of care principles with wraparound values and managed care technology.

  8. Choices Care Management • More than 220 employees • $35 million annual budget • More than 1300 youth served in child and family teams daily • Working across ALL childserving systems – 60% child welfare Indiana Choices – Since 1997 Maryland Choices – Since 2005 DC Choices – Since 2008 Louisiana Choices – Since 2012

  9. Choices, Inc. • Adopted CANS in 2006 • Comprehensive version • 12 Life Domains • Outcomes Champion – Agency in 2007

  10. Outcomes Monitoring • Internal • Program effectiveness • Quality improvement • External • Adherence to contract requirements • Marketing to new partners and communities

  11. Successes • Have lots of CANS data • Multiple resources to analyze and report data • Outcomes and evaluation • Software development • Communications • Ability to look at trends over time

  12. Challenges • Difficult to compare our performance to others • Multiple versions of the CANS • Variation in how CANS is analyzed • Multiple tools used across communities • Need to establish meaningful performance expectations • Minimum levels of change • % youth expected to improve

  13. Important Points about the CANS

  14. Critical Elements of Communimetrics Measures • Partner Involvement • Malleable to the Organization • Just Enough Information Philosophy • Meaningfulness to Decision Process • Reliability at Item Level • Utility of Measure Based on its Communication Value

  15. “Unlike psychometric measures in which clinical significance is a more rigorous standard than statistical significance, any change on the CANS is clinically significant.” - Lyons (2009), Communimetrics: A Communication Theory of Measurement in Human Service Settings

  16. Total Clinical Outcomes Management

  17. Methods for Analyzing the CANS • Dimension-Level Analyses • Item-Level Analyses

  18. Dimension-Level Analyses

  19. Change in Dimension Scores • Analysis Steps • Sum items in a specified dimensions • Divide by the number of valid responses • Multiply by 10 • Conduct statistical analysis

  20. Change in Dimension Scores • Reporting Results • Intake and discharge means • Results of statistical analysis • Statistically significant change in scores between intake and discharge • Benchmarks • Accepted statistical criteria • None available for clinical significance

  21. Change in Dimension Scores • Advantages • Uses well known statistical methods • Statistical significance has a commonly understood meaning • Disadvantages • Statistical significance not always indicative of clinical significance • Does not communicate results in terms of number of youth showing improvement

  22. Any Improvement in Functioning • Analysis Steps • Calculate intake and discharge mean scores • Identify youth with lower scores at discharge • Intake Mean Score > Discharge Mean score • Divide by # youth in sample

  23. Any Improvement in Functioning • Reporting Results • % of youth with any improvement in functioning • Benchmarks • N/A

  24. Any Improvement in Functioning • Advantages • Simple to analyze • Easy to explain methodology • Challenges • Lack of established benchmarks • Difficult to communicate that change is clinically meaningful

  25. Reliable Change • Equation • RCI = 1.28 * SD * SQRT(1 – Reliability) • Analysis Steps • Compute the RCI • Calculate change in intake and discharge mean scores • Identify youth with change in scores >= RCI • Divide by # youth in sample

  26. Reliable Change • Reporting Results • % of youth with a reliable improvement in functioning • Benchmarks • 60-80% of youth expected to improve in at least one of the dimensions measured • 20-40% of youth expected to improve in a specific dimension

  27. Reliable Change • Advantages • Clearly defined method • Available benchmarks • Challenges • Difficult for program staff to interpret and communicate results • Results include youth with no needs at intake

  28. Actionable Needs • Analysis Steps • Count the number of needs rated as a 2 or 3 within each dimension • Compare needs at Intake and Discharge

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