1. An outcome evaluation of residential care
Malin Hultman

2. 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?

3. 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

4. Design
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

5. 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

6. Ethical aspects Ethical assessment approved by ethical committee
Everyone gets treatment – no waiting list
Written consent from the youths
Relatively few measurement instruments

7. Target population Youths 14 – 18 years placed within SiS
In need of treatment for severe behavioral problems and meet inclusion criteria for the MultifunC-program
Assessed as ”high risk” according to YLS/CMI (cut off 23)

8. 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

9. Outcome/Measurements
Instrument Problem area/Outcome ADAD Addiction, family relations friends YSR Psychosocial problems SRD Delinquency Plus baseline data from YLS/CMI National register information on recidivism, out-of-home placements, education, employment, social services.

10. Study population Gender Boys Girls Total MultifunC 19 21 40 Control
We currently know that there were 5 breakdowns in the MultifunC group and 8 in the control group
Currently compiling data on later breakdowns

11. 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)

12. 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

13. Baseline – are the groups similiar? (ADAD)
MultifunC
Control
Sig?
Mother´s employment 73
79 % work
49 % work
yes
Father´s employment 69
86 % work
55 % work

14. Baseline- are the groups similar? YLS/CMI Total Score (baseline)
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

15. 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)
Average score for entire group 27
No gender differences - for both groups

16. 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!