Evaluation

Using Data for Lasting Change

Good decisions are informed by good data.

We design and implement community-based evaluation and research using relevant, innovative, and cost-effective methods and strategies to address complex social issues. We seek opportunities to engage research participants and team members with lived experience and employ community-based participatory research methods to improve outcomes for marginalized populations through person-centered care, recovery and stable housing, health and wellness.

We also know that lasting organizational change is dynamic, iterative, and reliant on continuous feedback and improvements. To support clients through learning, implementation, and program development, we monitor progress over time—a strategy that fosters accountability.

C4 Innovations utilizes several guiding frameworks to ensure that all studies and projects are:

Scientifically rigorous
Using state-of-the-art methodologies and practices
Identifying clear research questions
Developing and implementing evidence-based practices
Account for the needs of participants as well as the context of their lives
Committed to closing the gap between research and implementation
Rooted in community-based participatory research
Dedicated to consumer input at all stages of the project
Culturally responsive and competent
Designed to improve and refine practice and build community capacity
Focused on quality improvement and feedback
Committed to widespread dissemination of study findings to the field

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Preventing Substance Use for At Risk Adolescents

We developed and evaluated an extended, brief mentoring intervention for adolescents at risk of substance use. The intervention—Project Amp—is delivered by young adult peer mentors with lived experience of recovery.

It uses a Screening, Brief Intervention, and Referral to Treatment (SBIRT) framework to reduce risk factors and enhance protective factors. Following a collaborative design process involving local and national stakeholders across prevention, treatment, recovery, education, and health care, the intervention was tested at six pilot sites—three health care and three school-based settings—in communities across the U.S.

Data were obtained from multiple sources: youth, who completed team-developed surveys; standardized instruments, including CRAFFT, Resistance to Peer Influence measure, Schwarzer Self-Efficacy scale, Adolescent Coping Orientation for Problem Experiences, WHOQOL-BREF [Quality of Life], Perception of Harm survey; and focus groups. In addition, mentors completed team-developed surveys, semi-structured individual interviews, and focus groups about their experiences and perceived impact of Project Amp. Site staff also completed semi-structured interviews. The first phase of research indicated preliminary effectiveness and feasibility. We are now developing a fully-powered randomized controlled trial in school settings to determine effectiveness, explore formalized roles for young peers, and advance the study of best practices in youth substance use prevention and early intervention. Learn more.

SPARC: A C4 Racial Equity Initiative

C4 Innovations is leading a dual research-action project to better understand the experiences of homelessness among people of color and implement racial equity into homeless services to reduce racial disparities and homelessness rates. Following a successful Phase 1 implementation...

we received a five-year Phase 2 grant from the Oak Foundation to continue a mixed-methods evaluation effort. The outcome evaluation draws upon data, including initial and annual needs assessments for participating communities; training and technical assistance assessments; community-specific outcomes and progress on individualized and common structural change objectives; analytics from virtual learning communities; and data analysis reports based on quantitative and qualitative data collection to measure short-term and intermediate outcomes. We are examining and quantifying change at system, policy, workforce, and individual levels. Learn more.

Recovery Planning Toolkit

With Phase I funding from National Institute of Mental Health, we collaborated with Yale University’s Program for Recovery and Community Health (PRCH) to adapt PRCH’s evidence-based training for Person-Centered Planning into Recovery Roadmap, an online...

interactive, and educational recovery planning toolkit. Recovery Roadmap is designed to be used jointly by mental health service recipients and their providers. Phase I indicated that service recipients responded positively to Recovery Roadmap and used the experience to partner more effectively with their providers—making gains in recovery as measured by statistically significant improvements in the Recovery Markers Questionnaire.

During Phase II, we are expanding the toolkit by developing a Coaching and Support Center resource for providers and conducting a rigorous study. Using a randomized stepped wedge design, participants will serve as their own comparison group based on an observation period then implementation of Recovery Roadmap. The study is being conducted with 30 mental health practitioners and 120 service recipients in community support programs in Connecticut. Quantitative data will be collected at 4 time points with practitioners and service recipients using standardized instruments (Person-Centered Care Questionnaire-client and provider versions; Helping Relationship Inventory-client and worker versions; and Recovery Knowledge Inventory) and team-developed surveys (Network Analytics/Sociometric survey and knowledge assessments). This mixed-methods study also includes qualitative semi-structured interviews with practitioners and administrators to examine adoption and sustainability. Learn more about our work to support behavioral health and recovery.

Recovery Housing Environmental Scan in Ohio

We staff completed an environmental scan focused on recovery housing in Ohio. The project sought to identify and describe the current state of recovery housing across communities; effective models, key elements, and promising practices; funding and technical assistance...

needs; and legal and regulatory considerations. Findings were intended to inform policy changes, best practices, and training resources with the goal of increasing recovery housing capacity in the state.

Key activities included a literature review; analysis of state and federal housing regulations relevant to recovery housing in Ohio; telephone and in-person key informant interviews with 24 national experts and stakeholders; six site visits to programs representing various recovery housing models in each region; and four focus groups with community stakeholders. Following these data collection activities, team members reviewed and coded notes and identified salient themes to be used as the basis for a comprehensive report of findings and recommendations. This project was funded by the Ohio Department of Mental Health and completed in collaboration with the Ohio Council on Behavioral Health & Family Services Providers. Learn more about our work on recovery housing.

C4 strives to create a research climate that promotes objectivity in research by establishing standards such that the design, conduct, and reporting of Public Health Service of the U.S. Department of Health and Human Services, including the National Institutes of Health (NIH) funded research is free from bias resulting from financial conflict of interest (FCOI). Learn more.