A social experiment in joining up services :

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A social experiment in joining up services
Evaluating outcomes of the YP4 trial Dr Marty
Grace YP4 Outcome Evaluator Marty.Grace_at_vu.edu.a
u lcoventry_at_hanover.org.au
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YP4

• YP4 is a trial of
• joined up services for homeless jobseekers aged
  18-35
• YP4 is a joint initiative of
• Hanover Welfare Services (auspice)
• Loddon Mallee Housing Services
• Brotherhood of St Laurence
• Melbourne Citymission

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Key Elements

• Resourced case management
• Access to a flexible pool of resources
• Timely, individualised assistance
• Negotiated pathways to employment
• Immediate access to training, employment
  assistance and work opportunities
• Assistance to resolve housing crisis
• Commitment to secure housing and a living wage

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Trial design
YP4 is designed as a trial with eligible
participants randomly assigned to one of two
groups. One group receive services in the
standard way and the other receive their services
in a joined up way
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The Evaluation Agenda

• Ethics and Evaluation Advisory Group
• Framework and Plan
• Three components
• outcome
• process
• financial
• External evaluators engaged University of
  Melbourne and Victoria University

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Outcome Evaluation Research Question

• By joining up services and programs, does YP4
  assist participants to progress along a pathway
  that will achieve more sustainable employment and
  housing outcomes than would current interventions
  and if so, do those outcomes persist over time?

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Specific Aims

• 1. To investigate the outcomes for young people
  participating in the YP4 trial
• 2. To feed back information on impacts of the
  trial to the sponsor organisations
• To assist sponsor organisations to understand and
  articulate the policy and service delivery
  implications of the findings and
• To work with sponsor organisations to publicise
  the project findings and their implications.

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Research design

• Critical
• Longitudinal
• Iterative
• Randomised controlled trial
• Compare J group (Joined up services) outcomes
  with S group (Standard services) outcomes
• YP4 Objectives focus the outcome evaluation

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YP4 Objectives

• Enhance participants employability and reliance
  on income from work
• Improve the housing situation of trial
  participants (in terms of appropriateness,
  accessibility, affordability, and
  security/stability)
• Improve participants health and wellbeing
• Better integrate trial participants into their
  communities
• Join up housing, employment and personal support
  services for trial participants

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Data Collection

• Annual collection of data from existing data sets
  (groups S and J participants n415) for four
  years.
• Quarterly collection of data from service
  providers (relating to group J participants only
  n228) for two years
• Individual interviews with group S and J
  participants (n415) at intervals of 0, 12, 24,
  36 and 48 months
• Up to eight focus groups over two years

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Existing data sets

• The Department of Employment and Workplace
  Relations (DEWR)
• Supported Accommodation Assistance Program (SAAP)
  providers
• Transitional Housing Management (THM) service
  providers
• the Department of Family and Community Services
  (FACS)
• Centrelink
• The (State) Office of Housing
• The Department of Victorian Communities
• Brotherhood of St Laurence
• Hanover Welfare Services
• Loddon Mallee Housing Services and
• Melbourne Citymission

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Interviews

• Conducted at 0 months, 12 months, 24 months, 36
  months and 48 months
• By telephone or face-to-face
• Conducted by Centrelink social workers (in-kind
  contribution)
• Participants will receive 30 worth of vouchers
  in return for each interview

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Ethics of a social experiment

• Design J Group and S Group
• Random allocation
• Intention to compare outcomes
• Does this amount to withholding treatment?
• An unfortunate experimentThe full story behind
  the inquiry into cervical cancer treatment by
  Sandra Coney (1988) See http//www.womens-health.o
  rg.nz/cartwright/unfortunate.htm

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Are we withholding treatment?

• S group participants receive standard services.
  They do not lose any entitlement
• J group participants receive joined up services.
  They get something extra
• Answer We are not withholding anything.
• However, people are randomly assigned to one
  group or the other. Shouldnt services go to
  those most in need?
• Answer Centrelink already has procedures for
  assessing needs and allocating additional
  resources to those most in need. YP4 does not
  change this

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If joined up services are a good thing, shouldnt
everyone get them?

• Trials try out an apparently good idea and
  produce evidence before funding bodied commit to
  broader implementation
• YP4 comparison group is drawn from the same area
• Are joined up services necessarily a good thing?
• PRISM see http//www.latrobe.edu.au/mchr/prism/

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Nothing new

• Case management and service coordination have
  been around for years
• YP4 joins up at system, political and governance
  levels as well as service delivery

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References
Coney, Sandra 1998, The unfortunate experiment
the full story behind the inquiry into cervical
cancer treatment, Penguin, Auckland. Extract
available http//www.womens-health.org.nz/cartwrig
ht/unfortunate.htm, accessed 23-2-06. MCHR 2006,
PRISM Website, available http//www.latrobe.edu.au
/mchr/prism/, accessed 23-2-06.
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