Critical Time Intervention for People Leaving Shelters in the Netherlands: Assessing Fidelity and Exploring Facilitators and Barriers

Abstract

International dissemination of evidence-based interventions calls for rigorous evaluation. As part of an evaluation of critical time intervention (CTI) for homeless people and abused women leaving Dutch shelters, this study assessed fidelity in two service delivery systems and explored factors influencing model adherence. Data collection entailed chart review (n = 70) and two focus groups with CTI workers (n = 11). The intervention obtained an overall score of three out of five (fairly implemented) for compliance fidelity and chart quality combined. Fidelity did not differ significantly between service systems, supporting its suitability for a range of populations. The eight themes that emerged from the focus groups as affecting model adherence provide guidance for future implementation efforts.Electronic supplementary materialThe online version of this article (doi:10.1007/s10488-015-0699-9) contains supplementary material, which is available to authorized users.

The effectiveness of critical time intervention for abused women leaving women’s shelters: a randomized controlled trial

“…The scale items are rated on a 5-point scale ranging from not implemented (1) to ideally implemented (5). The intervention in this study obtained a fidelity score of 3, indicating that CTI was fairly implemented (de Vet et al 2017b ; Conover 2012, unpublished manuscript).…”

“…The intervention in this study obtained a fidelity score of 3, indicating that CTI was fairly implemented (de Vet et al 2017b ; Conover 2012, unpublished manuscript).…”

“…Principles from the strengths model (Rapp and Goscha 2006 ) were integrated in CTI to ensure continuity in service approach during the transition. We conducted a fidelity assessment for a representative subsample of 35 women assigned to CTI and reported the results in previous work (de Vet et al 2017b ). Fidelity was measured using the CTI fidelity scale, a quantitative tool developed by Conover and Herman (2007, unpublished manuscript).…”

“… A similar table is provided in an article by de Vet et al ( 2017a ) a A detailed description of the materials can be found elsewhere (de Vet et al 2017b ) …”

“…We hypothesized that CTI is more effective than care-as-usual in: (1) improving QoL (primary outcome); (2) preventing re-abuse, reducing symptoms of depression, PTSD, and psychological distress, improving self-esteem (secondary outcomes); and (3) improving family support, social support, and the fulfillment of care needs (intermediate outcomes). We performed a fidelity assessment with a subsample of 35 women assigned to CTI (de Vet et al 2017b ).…”