Impact of referral source and study applicants' preference for randomly assigned service on research enrollment, service engagement, and evaluative outcomes
Authors
Macias, CathaleeneBarreira, Paul J.
Hargreaves, William A.
Bickman, Leonard
Fisher, William H.
Aronson, Elliot
UMass Chan Affiliations
Department of PsychiatryDocument Type
Journal ArticlePublication Date
2005-04-01Keywords
AdultCommunity Mental Health Services
Employment, Supported
Female
Health Services Research
Humans
Male
Mental Disorders
Motivation
Outcome Assessment (Health Care)
*Patient Participation
Patient Satisfaction
Proportional Hazards Models
Randomized Controlled Trials as Topic
*Referral and Consultation
Research Design
Research Subjects
Researcher-Subject Relations
Salaries and Fringe Benefits
Survival Analysis
Health Services Research
Mental and Social Health
Psychiatric and Mental Health
Psychiatry
Psychiatry and Psychology
Metadata
Show full item recordAbstract
OBJECTIVE: The inability to blind research participants to their experimental conditions is the Achilles' heel of mental health services research. When one experimental condition receives more disappointed participants, or more satisfied participants, research findings can be biased in spite of random assignment. The authors explored the potential for research participants' preference for one experimental program over another to compromise the generalizability and validity of randomized controlled service evaluations as well as cross-study comparisons. METHOD: Three Cox regression analyses measured the impact of applicants' service assignment preference on research project enrollment, engagement in assigned services, and a service-related outcome, competitive employment. RESULTS: A stated service preference, referral by an agency with a low level of continuity in outpatient care, and willingness to switch from current services were significant positive predictors of research enrollment. Match to service assignment preference was a significant positive predictor of service engagement, and mismatch to assignment preference was a significant negative predictor of both service engagement and employment outcome. CONCLUSIONS: Referral source type and service assignment preference should be routinely measured and statistically controlled for in all studies of mental health service effectiveness to provide a sound empirical base for evidence-based practice.Source
Am J Psychiatry. 2005 Apr;162(4):781-7. Link to article on publisher's siteDOI
10.1176/appi.ajp.162.4.781Permanent Link to this Item
http://hdl.handle.net/20.500.14038/45214PubMed ID
15800153Related Resources
Link to Article in PubMedae974a485f413a2113503eed53cd6c53
10.1176/appi.ajp.162.4.781
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