DHS Project Director Theodora Binion-Taylor
DHS Contract Mgr Carolyn Hartfied
Annual Grant $ $500,000
Evaluation Name & Contact Info

Emma J. Flowers

773-271-2348

IOTA, Inc.

Annual Eval $ $90,000
Contact for a copy of evaluation reports Richard Sherman, Ph.D./773-478-9265
Funding Source SAMHSA/CSAT
Eval Period 9/30/2007 - 9/29/2012

Targeted Capacity Expansion and HIV Services (TCE/HIV) Grant - Family Guidance Centers, Inc. (Chicago)

In September 2007, IDHS/DASA was awarded funding of this five-year TCE/HIV project through an application submitted to Center for Substance Abuse (CSAT). The purpose of this project is to expand and enhance the outpatient methadone treatment (OMT) services that are available to Chicago community areas. The purpose of this TCE/HIV project is to expand and enhance the evidence-based outpatient methadone treatment (OMT) services that are available to African American and Hispanic/Latino injecting males, to include Men who have sex with other Men (MSM), who are residents of the near north and west side City of Chicago community areas that have high rates of HIV infection and AIDS.

It is projected that 250 unduplicated minority male clients will be served through these expanded and enhanced services during the five years of CSAT funding. IDHS/DASA will function as the grantee and will be responsible for all grant administration requirements. IDHS/DASA has contracted with Family Guidance Centers, Inc. (FGC) to provide the proposed expanded and enhanced services. IOTA, Inc. was contracted to implement an evaluation plan for this grant that includes administration of the CSAT Government Performance and Results Act (GPRA) items at admission, discharge from project services, and six-month post-admission follow-up. The evaluation is being conducted under the direction of Richard E. Sherman, Ph.D. Other IOTA staff assist in the data collection, processing, analysis, and reporting activities described below.

Capacity

This project's application contained a statement of goals and objectives that included a proposed cumulative intake target of 250 unduplicated minority male clients over the five years of CSAT funding. As of July 14, 2009, 127 client intakes had been entered on the CSAT SAIS web site. This represents 133.7% of the cumulative target of 95 intakes up to this point. The following is a summary of baseline characteristics of the 127 minority male clients who have thus far been admitted to treatment through this TCE/HIV project.

  • The minority male clients thus far admitted to this TCE/HIV project are on average 41.8 years of age at time of admission. About two-thirds of the clients indicated African American as their race.
  • About one-third (34.6% - 44) of the admitted clients reported themselves to be of Hispanic ethnicity, with about two-thirds of these clients indicating that they are Puerto Rican.
  • Over one-third of the clients reported that they had not completed high school.
  • Only two of the admitted clients reported being employed full-time at time of admission and only four of the clients reported part-time employment. Over 60% of the clients reported that they were unemployed not looking for work.
  • The admitted clients had an average income during the past 30 days from wages of less than $55, and an average income during the past 30 days from illegal sources of nearly $430.
  • About 35% of the clients reported living in their own home or apartment and over 50% reported living in someone else's home or apartment. Therefore, the majority of admitted clients reported unstable living arrangements.
  • The majority of admitted clients reported some level of feelings of stress, reduction in important activities, and emotional problems during the 30 days prior to admission that they attributed to their substance use.
  • Over one-third of the clients rated their current health as "fair" or "poor." Over 10% of the clients reported having visited an emergency room for physical health problems during the 30 days prior to admission.
  • Over 40% of the clients stated that they had injected drugs during the 30 days prior to admission.
  • Over one-fifth of the admitted clients reported being on probation or parole at time of admission and nearly 10% reported that they were awaiting trial or sentencing.
  • Over 50% of the clients reported unprotected sexual contacts during the 30 days prior to admission. Three of the clients reported unprotected sexual contacts with a drug user and 20 reported unprotected contacts with someone "high" on some substance.
  • Relatively few of the clients reported attendance at any type of recovery support group during the 30 days prior to admission. However, about two-thirds reported interactions with family and/or friends who are supportive of recovery during the 30 days prior to admission.
  • Over one-third of the admitted clients reported serious depression, over one-third reported serious anxiety or tension, and nearly 20% reported trouble concentrating or remembering during the 30 days prior to admission that were not attributable to their substance use. However, only three of the admitted clients reported having taken prescribed psychiatric medications during that time period.
  • Over 70% of the clients reported having children. There was an average of three children among the admitted clients. Six of the clients reported having children living elsewhere due to a court order, and four reported having lost custody of their children.
  • The clients thus far admitted to this project reported an average of 26.7 days of heroin use during the 30 days prior to admission. These clients also reported an average of 5.3 days of cocaine use and an average of 1.4 days of alcohol use during the 30 days prior to admission.

Effectiveness

As part of this TCE/HIV project evaluation, attempts are being made to administer the expanded GPRA data collection tool at six-months post-admission. This is the follow-up interval required by CSAT for TCE/HIV projects. The first clients admitted to this project came due for six-month follow-up during May 2008. IOTA is responsible for conducting these six-month follow-up interviews. As of this interim report's preparation, a total of 98 completed follow-up tools were received for the 112 clients who had come due for six-month follow-up. This represents an interim follow-up rate of 87.5%. Partial results from an interim analysis of Family Guidance client follow-up responses are provided in the below table. This analysis is based on the 100 paired baseline and six-month follow-up interviews that were downloaded from the CSAT SAIS web site on July 9, 2009. One of these interviews was conducted prior to opening of the client's follow-up window. The following is a summary of findings from these interim results. The summary of interim evaluation findings is arranged by GPRA domain.

Self-sufficiency

  • There was a statistically significant change from admission to six-month follow-up in the employment status pattern among the interviewed clients. Only four of the clients was employed admission, but at six-month follow-up 17 reported being employed part-time. Although this change is statistically significant, a greater increase in reported employment at follow-up would be desirable. However, the fact that this is a relatively older client population with a relatively low rate of high school completion, present substantial challenges to attaining improved changes in employment.
  • There was a significant increase from baseline to six-month follow-up among the interviewed clients in average income from wages during the past 30 days.

Social Support/Functioning

  • There was a significant decrease from baseline to six-month follow-up among the interviewed clients in average income from illegal sources.
  • There was a significant increase from baseline to follow-up among the interviewed clients in regards to the percentage who reported attendance during the past 30 days at non-FBO support groups and other groups that support recovery.

Alcohol and Drug Use

  • There were significant reductions at time of follow-up in the percentages of clients who reported feelings of stress, reduction in important activities, and emotional problems due to substance abuse during the past 30 days.
  • At time of six-month follow-up clients reported a significant reduction during the past 30 days in average days of cocaine, marijuana and heroin use as compared to the 30 days prior to admission. Over 40% of the interviewed clients reported abstinence from heroin during the 30 days prior to their follow-up interviews.
  • There was also a significant reduction from baseline to six-month follow-up in the percentage of clients who reported injecting drugs during the past 30 days.

Mental/Physical Health Status

  • There was a statistically significant increase from baseline to follow-up in the percentage of clients who reported being extremely bothered by psychological and/or emotional issues. Although not statistically significant, there were increases from baseline to follow-up in average days of various self-reported mental health issues during the previous 30 days. Participation in the treatment process may account for clients being more cognizant of these mental health issues. Nevertheless, the program may want to examine the extent to which mental health issues are addressed during treatment.

Targeted Capacity Expansion and HIV Services Grants (El Rincon and Family Guidance Centers)

Indicators / Measures  Tools / Instruments / Data Sources Other Deliverables / Comments

Process Evaluation Questions

-Was the project implemented as intended?

-What types of project plan deviations occurred, what led to the deviations, and what effects did the deviations have on the project?

-What are the staffing, logistical and cost characteristics of the delivered services?

Outcome Evaluation Questions

-What are the characteristics of the clients who participate in the implementation of the evidence based substance abuse treatment services?

-What outcomes are evident among the clients who participate in the expanded and enhanced services?

-What is the durability of observed effects and what individual factors are related to observed effects?

-To what extent did the project achieve its quantitative objectives for client admission and service delivery? What are the stakeholder group perceptions of project services?

GPRA

Client Satisfaction Survey

Focus Groups

Not Applicable