ACT Fidelity in Ontario: Measuring Adherence to the Model

GeorgeLindsey,; KiddSean,; WongMaria,; HarveyRachel,; BrowneGina,

doi:10.7870/cjcmh-2010-0036

Cited by 6 publications

(4 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…With respect to implications, these findings support the utility of approaches such as assertive community treatment and intensive case management that focus on those demonstrating very difficult transitions to community and limited gains in hospital. 33,34 Also supported are implications for greater gains in shorter periods and interventions that might enhance such gains, in scenarios in which acuity is driven to a greater extent by environmental stressors and/or addictions. More broadly, systematic approaches are needed, such as integrated care pathways, 35 as it is clear that there are diverse service utilisation patterns that are predictable and likely require quite different approaches within the same diagnostic category.…”

Section: Discussionmentioning

confidence: 99%

Patient Characteristics, Length of Stay, and Functional Improvement for Schizophrenia Spectrum Disorders: A Population Study of Inpatient Care in Ontario 2005 to 2015

et al. 2016

Self Cite

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

Patient Characteristics, Length of Stay, and Functional Improvement for Schizophrenia Spectrum Disorders: A Population Study of Inpatient Care in Ontario 2005 to 2015

et al. 2016

Self Cite

View full text Add to dashboard Cite

show abstract

“…Even though some findings in the Norwegian study can be explained by national factors as education of health professionals and organisation of mental health care in Norway, the pattern for the Washington State teams and the Norwegian teams suggest additional cross-cultural explanations. Fidelity assessments in other countries, like Canada, also showed lower fidelity ratings in the areas of recovery, specifically for employment and substance abuse, and staff working in these areas than for core ACT practices [45].…”

Section: Discussionmentioning

confidence: 99%

Model fidelity and team members’ experiences of assertive community treatment in Norway: a sequential mixed-methods study

Odden

Landheim

Clausen

et al. 2019

Int J Ment Health Syst

View full text Add to dashboard Cite

BackgroundAssertive community treatment (ACT) is an evidence-based treatment for people with severe mental illness, and this model is used widely throughout the world. Given the various adaptations in different contexts, we were interested in studying the implementation and adaptation of the ACT model in Norway. The first 12 Norwegian ACT teams were established between 2009 and 2011, and this study investigated the teams’ model fidelity and the team members’ experiences of working with ACT.MethodsTo investigate implementation of the ACT model, fidelity assessments were performed 12 and 30 months after the teams started their work using the Tool for Measurement of Assertive Community Treatment (TMACT). Means and standard deviations were used to describe the ACT teams’ fidelity scores. Cohen’s effect size d was used to assess the changes in TMACT scores from the first to second assessment. Qualitative focus group interviews were conducted in the 12 teams after 30 months to investigate the team members’ experiences of working with the ACT model.ResultsThe fidelity assessments of the Norwegian teams showed high implementation of the structural and organizational parts of the ACT model. The newer parts of the model, the recovery and evidence-based practices, were less implemented. Four of the six subscales in TMACT improved from the first to the second assessment. The team members experienced the ACT model to be a good service model for the target population: people with severe mental illness, significant functional impairment, and continuous high service needs. Team members perceived some parts of the model difficult to implement and that it was challenging to find effective ways to collaborate with existing health and social services.ConclusionThe first 12 Norwegian ACT teams implemented the ACT model to a moderate degree. The ACT model could be implemented in Norway without extensive adaptations. Although the team members were satisfied with the ACT model, especially the results for their service users, inclusion of the ACT team to the existing service system was perceived as challenging.

show abstract

“…Assertive Community Treatment (ACT) teams in the province of Ontario, Canada have been systematically implemented since 1998, with 79 ACT teams currently in operation [ 20 ]. Though Toronto has a high concentration of services, including ACT, individuals with complex health and social needs such as intellectual and developmental disabilities, traumatic brain injury, co-morbid substance use conditions, and co-morbid personality disorders, continue to face barriers in accessing community supports of high intensity.…”

Section: Introductionmentioning

confidence: 99%

Building flexibility and managing complexity in community mental health: lessons learned in a large urban centre

et al. 2018

View full text Add to dashboard Cite

BackgroundAcross many jurisdictions, adults with complex mental health and social needs face challenges accessing appropriate supports due to system fragmentation and strict eligibility criteria of existing services. To support this underserviced population, Toronto’s local health authority launched two novel community mental health models in 2014, inspired by Flexible Assertive Community Team principles. This study explores service user and provider perspectives on the acceptability of these services, and lessons learned during early implementation.MethodsWe purposively sampled 49 stakeholders (staff, physicians, service users, health systems stakeholders) and conducted 17 semi-structured qualitative interviews and 5 focus groups between October 23, 2014 and March 2, 2015, exploring stakeholder perspectives on the newly launched team based models, as well as activities and strategies employed to support early implementation. Interviews and focus groups were audio recorded, transcribed verbatim and analyzed using thematic analysis.ResultsFindings revealed wide-ranging endorsement for the two team-based models’ success in engaging the target population of adults with complex service needs. Implementation strengths included the broad recognition of existing service gaps, the use of interdisciplinary teams and experienced service providers, broad partnerships and collaboration among various service sectors, training and team building activities. Emerging challenges included lack of complementary support services such as suitable housing, organizational contexts reluctant to embrace change and risk associated with complexity, as well as limited service provider and organizational capacity to deliver evidence-based interventions.ConclusionsFindings identified implementation drivers at the practitioner, program, and system levels, specific to the implementation of community mental health interventions for adults with complex health and social needs. These can inform future efforts to address the health and support needs of this vulnerable population.Electronic supplementary materialThe online version of this article (10.1186/s12888-018-1597-y) contains supplementary material, which is available to authorized users.

show abstract

ACT Fidelity in Ontario: Measuring Adherence to the Model

Cited by 6 publications

References 24 publications

Patient Characteristics, Length of Stay, and Functional Improvement for Schizophrenia Spectrum Disorders: A Population Study of Inpatient Care in Ontario 2005 to 2015

Patient Characteristics, Length of Stay, and Functional Improvement for Schizophrenia Spectrum Disorders: A Population Study of Inpatient Care in Ontario 2005 to 2015

Model fidelity and team members’ experiences of assertive community treatment in Norway: a sequential mixed-methods study

Building flexibility and managing complexity in community mental health: lessons learned in a large urban centre

Contact Info

Product

Resources

About