Fidelity to Assertive Community Treatment Program Standards: A Regional Survey of Adherence to Standards
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In 2004, the Ontario government approved revised program standards for the operation of Assertive Community Treatment (ACT) programs in the province. This paper reports on results from The 2005 Survey of ACT Programs in Ontario. We provide a profile of ACT programs in the province and identify respondents’ perceptions of the extent to which the revised program standards have been complied with and are thought to be essential for the effective operation of an ACT program. Program Coordinators completed surveys for 56 (85%) of the 66 ACT programs in existence at the time. None of the Program Coordinators reported that their ACT program was fully compliant with all program standards and only 4% of ACT programs were identified as being fully compliant with more than 75% of the program standards. Conclusions are provided and the broader implications of lower fidelity to program standards are discussed.
KeywordsHealth policy Mental health services Assertive community treatment Program standards Fidelity
This research was funded by a grant from the Arts Research Board, McMaster University. We would like to thank research associates Darlene Kindiak and Joanne Menchions and research assistants, Cheryl Gustafson, and Michael Schatte for their assitance with this study, along with all of the ACT Program Coordinators who particiapted in the study. We are also grateful for the contributions of the anonymous reviewers.
- Banks, S., McHugo, G. J., Williams, V., Drake, R. E., & Shinn, M. (2001). A prospective meta-analitic approach in a mulit-site study of homelessness revention. In J. M. Herrell & R. B. Straw (Eds.), Conducting multiple site evaluations in real-world settings (Vol. 94, pp. 45–59). New Directions for Evaluation, San Francisco, CA: Jossey-Bass.Google Scholar
- Bond, G. R., Williams, J., & Evans, L. (2000). PN-44-psychiatric rehabilitation fidelity toolkit. Cambridge, MA: Human Services Research Institute.Google Scholar
- Humberstone, V., Vanderpyl, J., Saunders, K., Lurie, S., McKee, H., Deuchar, N., et al. (2008). International comparative ACT study process and data: How ACT teams compare in Toronto, Birmingham, Nashville and Auckland. The International Journal of Leadership in Public Service, 4(1), 41–55.CrossRefGoogle Scholar
- Isett, K. R., Burnam, M. A., Coleman-Beattie, B., Hyde, P. S., Morrissey, J. P., Magnabosco, J., et al. (2008). The role of state mental health authorities in managing change for the implementation of evidence-based practices. Community Mental Health Journal, 58, 914–921.Google Scholar
- Latimer, E. A. (1999). Economic impacts of assertive community treatment: A review of the literature. Canadian Journal of Psychiatry, 44(5), 443–454.Google Scholar
- Mobray, C. T., Holter, M. C., Teague, G. B., & Bybee, D. (2003). Fidelity criteria: Development, measurment, and validation. American Journal of Evaluation, 24(3), 315–340.Google Scholar
- Ontario Ministry of Health. (1998). Recommended standards for assertive community treatment teams. Toronto, Ontario: Ontario Ministry of Health.Google Scholar
- Ontario Ministry of Health. (2005). Ontario Program Standards for ACT Teams, 2nd edition, October 2004, Ministry of Health and Long-Term Care, Updated January 2005. http://www.health.gov.on.ca/english/public/pub/ministry_reports/mentalhealth/act_standards.pdf.
- Randall, G. E., & Wakefield, P. A. (2005). Ontario ACT program fidelity tool. Unpublished report.Google Scholar