Att visa fotnot, datum, sidnummer Klicka på fliken ”Infoga”och klicka på ikonen sidhuvud/sidfot Klistra in text: Klistra in texten, klicka på ikonen (Ctrl), välj ”Behåll endast text” Presentationsrubrik: Century Gothic, bold 26pt Rubrik: Century Gothic, bold 14pt Namn: Century Gothic, bold 14pt An outcome evaluation of residential care Malin Hultman

Att visa fotnot, datum, sidnummer Klicka på fliken ”Infoga”och klicka på ikonen sidhuvud/sidfot Klistra in text: Klistra in texten, klicka på ikonen (Ctrl), välj ”Behåll endast text” Overview • Background- why an evaluation of MultifunC is needed • Design and process • Baseline data, including tests of differences between groups • What are the situation for the youths at 12 months follow-up?

Att visa fotnot, datum, sidnummer Klicka på fliken ”Infoga”och klicka på ikonen sidhuvud/sidfot Klistra in text: Klistra in texten, klicka på ikonen (Ctrl), välj ”Behåll endast text” Punktlista nivå 1: Century Gothic, normal 19pt Nivå 2: Century Gothic normal 19pt Rubrik: Century Gothic, bold 33pt The knowledge base of residential care in Sweden • Few outcome evaluations of the treatment effects of residential care -High recidivism -High re-placement in residential care • Longitudinal register studies show that: -Lower rate of education -Bad health -Increased risk for early death • Therefore, it was decided that MultifunC would be evaluated already at the programme-development stage

Att visa fotnot, datum, sidnummer Klicka på fliken ”Infoga”och klicka på ikonen sidhuvud/sidfot Klistra in text: Klistra in texten, klicka på ikonen (Ctrl), välj ”Behåll endast text” Punktlista nivå 1: Century Gothic, normal 19pt Nivå 2: Century Gothic normal 19pt Rubrik: Century Gothic, bold 33pt Design 4 Has MultifunC reduced serious behavior problem among participants? • Quasi – experimental design • Experimental group vs control group (MultifunC vs ”Treatment as Usual, TAU”) • TAU consists of other equivalent treatment within SiS • Pretest/posttest – before treatment – 12 months – 24 months follow-up • Register follow-up up to 5 years

Att visa fotnot, datum, sidnummer Klicka på fliken ”Infoga”och klicka på ikonen sidhuvud/sidfot Klistra in text: Klistra in texten, klicka på ikonen (Ctrl), välj ”Behåll endast text” Punktlista nivå 1: Century Gothic, normal 19pt Nivå 2: Century Gothic normal 19pt Rubrik: Century Gothic, bold 33pt Timeline • Started in January 2010 • Recruitment continued until August 2012 • Have completed data collection at: – Baseline – 12 months • 24 month follow-up completed in a year

Att visa fotnot, datum, sidnummer Klicka på fliken ”Infoga”och klicka på ikonen sidhuvud/sidfot Klistra in text: Klistra in texten, klicka på ikonen (Ctrl), välj ”Behåll endast text” Punktlista nivå 1: Century Gothic, normal 19pt Nivå 2: Century Gothic normal 19pt Rubrik: Century Gothic, bold 33pt Ethical aspects • Ethical assessment approved by ethical committee • Everyone gets treatment – no waiting list • Written consent from the youths • Relatively few measurement instruments

Att visa fotnot, datum, sidnummer Klicka på fliken ”Infoga”och klicka på ikonen sidhuvud/sidfot Klistra in text: Klistra in texten, klicka på ikonen (Ctrl), välj ”Behåll endast text” Punktlista nivå 1: Century Gothic, normal 19pt Nivå 2: Century Gothic normal 19pt Rubrik: Century Gothic, bold 33pt Target population 1. Youths 14 – 18 years placed within SiS 2. In need of treatment for severe behavioral problems and meet inclusion criteria for the MultifunC-program 3. Assessed as ”high risk” according to YLS/CMI (cut off 23)

Att visa fotnot, datum, sidnummer Klicka på fliken ”Infoga”och klicka på ikonen sidhuvud/sidfot Klistra in text: Klistra in texten, klicka på ikonen (Ctrl), välj ”Behåll endast text” Punktlista nivå 1: Century Gothic, normal 19pt Nivå 2: Century Gothic normal 19pt Rubrik: Century Gothic, bold 33pt Inclusion process 1. First assessment from inclusion - and exclusion criteria Made by head office 2. Second assessment made with YLS/CMI Conducted by psychologists within SiS 3. Information about research project to youths and inquiry to participate 4. If “yes” to participate baseline measurement Inclusion process was continued until there were 40 individuals in both groups

Att visa fotnot, datum, sidnummer Klicka på fliken ”Infoga”och klicka på ikonen sidhuvud/sidfot Klistra in text: Klistra in texten, klicka på ikonen (Ctrl), välj ”Behåll endast text” Punktlista nivå 1: Century Gothic, normal 19pt Nivå 2: Century Gothic normal 19pt Rubrik: Century Gothic, bold 33pt Outcome/Measurements InstrumentProblem area/Outcome ADADAddiction, family relations friends YSRPsychosocial problems SRDDelinquency Plus baseline data from YLS/CMI National register information on recidivism, out-of-home placements, education, employment, social services.

Att visa fotnot, datum, sidnummer Klicka på fliken ”Infoga”och klicka på ikonen sidhuvud/sidfot Klistra in text: Klistra in texten, klicka på ikonen (Ctrl), välj ”Behåll endast text” Punktlista nivå 1: Century Gothic, bold 19pt Nivå 2: Century Gothic normal 19pt Rubrik: Century Gothic, bold 33pt Study population Gender BoysGirlsTotal MultifunC Control Total40 • We currently know that there were 5 breakdowns in the MultifunC group and 8 in the control group • Currently compiling data on later breakdowns

Att visa fotnot, datum, sidnummer Klicka på fliken ”Infoga”och klicka på ikonen sidhuvud/sidfot Klistra in text: Klistra in texten, klicka på ikonen (Ctrl), välj ”Behåll endast text” Punktlista nivå 1: Century Gothic, normal 19pt Nivå 2: Century Gothic normal 19pt Rubrik: Century Gothic, bold 33pt What do control group receive? 12 different units for boys and 10 different units for girls • What do both groups receive? – ART – Individual counselling – Token economy – Education (but see below) • What differs MultifunC from the control group? – Aftercare – Family therapy – Education (MultifunC group attends normal schools, control group often receive education at institutions)

Att visa fotnot, datum, sidnummer Klicka på fliken ”Infoga”och klicka på ikonen sidhuvud/sidfot Klistra in text: Klistra in texten, klicka på ikonen (Ctrl), välj ”Behåll endast text” Baseline – are the groups similiar? (ADAD) • No group differences in age • Average age 16 years • No group differences in birth country • Approx. 75% born in Sweden • No group differences in parents’ civil status • Approx. 36% of parents live together

Att visa fotnot, datum, sidnummer Klicka på fliken ”Infoga”och klicka på ikonen sidhuvud/sidfot Klistra in text: Klistra in texten, klicka på ikonen (Ctrl), välj ”Behåll endast text” n MultifunCControlSig? Mother´s employment % work49 % workyes Father´s employment % work55 % workyes Baseline – are the groups similiar? (ADAD)

Att visa fotnot, datum, sidnummer Klicka på fliken ”Infoga”och klicka på ikonen sidhuvud/sidfot Klistra in text: Klistra in texten, klicka på ikonen (Ctrl), välj ”Behåll endast text” Baseline- are the groups similar? YLS/CMI Total Score (baseline) • Total score: • No group differences • Average score for entire group 27 • No gender differences • Per area: • Majority high risk within: • Prior- and current offences (73%) • Education/Employment (65%) • Peer relations (61%) • Leisure/recreation (94%) • Remaining areas moderate risk or equal number moderate- and high risk

Att visa fotnot, datum, sidnummer Klicka på fliken ”Infoga”och klicka på ikonen sidhuvud/sidfot Klistra in text: Klistra in texten, klicka på ikonen (Ctrl), välj ”Behåll endast text” Baseline- are the groups similar? YSR • Internalizing problems: (N=78) • No group differences • Girls significantly higher scores than boys – for both groups • Girls mean 18 • Boys mean 11 • Externalizing problems: (N=78) • No group differences • Average score for entire group 27 • No gender differences - for both groups

Att visa fotnot, datum, sidnummer Klicka på fliken ”Infoga”och klicka på ikonen sidhuvud/sidfot Klistra in text: Klistra in texten, klicka på ikonen (Ctrl), välj ”Behåll endast text” Punktlista nivå 1: Century Gothic, normal 19pt Nivå 2: Century Gothic normal 19pt Rubrik: Century Gothic, bold 33pt Final words • Good collaboration between research team and organization • Long inclusion period • Difficult to find and get in contact with youths at follow- up • Large amount of resources… • But possible!

Att visa fotnot, datum, sidnummer Klicka på fliken ”Infoga”och klicka på ikonen sidhuvud/sidfot Klistra in text: Klistra in texten, klicka på ikonen (Ctrl), välj ”Behåll endast text” Rubrik: Century Gothic, bold 26pt For more information: