A Realist Evaluation of a Voluntary Sector Drop In Service for Veterans.

Karen Burnell, Emma Collins, Kim Gordon, Emina Hadziosmanovic, Alan Leonard, Chris Penney

Research output: Book/ReportBook

Abstract

Objectives: How best to support veterans is a key question for service providers and policy makers. The objectives of the current study were to evaluate a drop in service for veterans delivered by veterans, in terms of effectiveness and cost-utility.
Design: A realist evaluation was used to evaluate the drop in service. Realist evaluations seek to understand what works for whom and in what context, and are traditionally mixed method.
Methods: The realist evaluation comprised three Work Packages. Work Package 1 involved the development of the programme theory, based on stakeholder interviews, current evidence base, and organisation documentation. Work Package 2 was a retrospective study and included; a retrospective analysis of the service’s dataset of CORE outcomes, one-to-one interviews with veterans and service providers, and a survey of past and current users. Work Package 3 was a prospective study following new users for a maximum of 6 months, which included a cost utility analysis including use of the CSRI.
Results: A number of interesting themes arose from the components of the service, with each element providing vital triangulation. Two types of users emerged from the findings; those who access the service for the mental health provision and those who attend to receive practical support from attending agencies. The drop in service was seen as a safe haven, and the military-like environment acted as a core mechanism for change. Comparisons with other services, particularly NHS, were favourable. Cost utility analysis found that the service is cost-effective if improvement is maintained for one year.
Conclusions: VOS represents a trusted, familiar environment that meets a range of different needs. Despite this, there are areas that require consideration. Findings suggest that one size does not fit all; what works for those who present with psychological or physical need may not work for those who present with practical or social need. What might suit the former is a quieter drop in, with formal psychological assessment, risk monitoring, and where onward referral is efficient. The power of the military-like environment comes to the fore here as a mechanism. What suits the latter is a busier drop in, with no psychological assessment, and where agencies and service users can network. Of importance to this group is the efficiency of a ‘one stop shop’. What is important for both is greater privacy afforded to them while at the drop in and, arguably, a more frequent drop in.
Original languageEnglish
Commissioning bodyForces in Mind Trust
Publication statusPublished - 2018

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evaluation
utility analysis
costs
service provider
Military
triangulation
interview
risk assessment
documentation
privacy
mental health
stakeholder
monitoring
efficiency
evidence
Group

Cite this

Burnell, K., Collins, E., Gordon, K., Hadziosmanovic, E., Leonard, A., & Penney, C. (2018). A Realist Evaluation of a Voluntary Sector Drop In Service for Veterans.
Burnell, Karen ; Collins, Emma ; Gordon, Kim ; Hadziosmanovic, Emina ; Leonard, Alan ; Penney, Chris. / A Realist Evaluation of a Voluntary Sector Drop In Service for Veterans. 2018.
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title = "A Realist Evaluation of a Voluntary Sector Drop In Service for Veterans.",
abstract = "Objectives: How best to support veterans is a key question for service providers and policy makers. The objectives of the current study were to evaluate a drop in service for veterans delivered by veterans, in terms of effectiveness and cost-utility.Design: A realist evaluation was used to evaluate the drop in service. Realist evaluations seek to understand what works for whom and in what context, and are traditionally mixed method.Methods: The realist evaluation comprised three Work Packages. Work Package 1 involved the development of the programme theory, based on stakeholder interviews, current evidence base, and organisation documentation. Work Package 2 was a retrospective study and included; a retrospective analysis of the service’s dataset of CORE outcomes, one-to-one interviews with veterans and service providers, and a survey of past and current users. Work Package 3 was a prospective study following new users for a maximum of 6 months, which included a cost utility analysis including use of the CSRI.Results: A number of interesting themes arose from the components of the service, with each element providing vital triangulation. Two types of users emerged from the findings; those who access the service for the mental health provision and those who attend to receive practical support from attending agencies. The drop in service was seen as a safe haven, and the military-like environment acted as a core mechanism for change. Comparisons with other services, particularly NHS, were favourable. Cost utility analysis found that the service is cost-effective if improvement is maintained for one year.Conclusions: VOS represents a trusted, familiar environment that meets a range of different needs. Despite this, there are areas that require consideration. Findings suggest that one size does not fit all; what works for those who present with psychological or physical need may not work for those who present with practical or social need. What might suit the former is a quieter drop in, with formal psychological assessment, risk monitoring, and where onward referral is efficient. The power of the military-like environment comes to the fore here as a mechanism. What suits the latter is a busier drop in, with no psychological assessment, and where agencies and service users can network. Of importance to this group is the efficiency of a ‘one stop shop’. What is important for both is greater privacy afforded to them while at the drop in and, arguably, a more frequent drop in.",
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Burnell, K, Collins, E, Gordon, K, Hadziosmanovic, E, Leonard, A & Penney, C 2018, A Realist Evaluation of a Voluntary Sector Drop In Service for Veterans.

A Realist Evaluation of a Voluntary Sector Drop In Service for Veterans. / Burnell, Karen; Collins, Emma; Gordon, Kim; Hadziosmanovic, Emina; Leonard, Alan; Penney, Chris.

2018.

Research output: Book/ReportBook

TY - BOOK

T1 - A Realist Evaluation of a Voluntary Sector Drop In Service for Veterans.

AU - Burnell, Karen

AU - Collins, Emma

AU - Gordon, Kim

AU - Hadziosmanovic, Emina

AU - Leonard, Alan

AU - Penney, Chris

PY - 2018

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N2 - Objectives: How best to support veterans is a key question for service providers and policy makers. The objectives of the current study were to evaluate a drop in service for veterans delivered by veterans, in terms of effectiveness and cost-utility.Design: A realist evaluation was used to evaluate the drop in service. Realist evaluations seek to understand what works for whom and in what context, and are traditionally mixed method.Methods: The realist evaluation comprised three Work Packages. Work Package 1 involved the development of the programme theory, based on stakeholder interviews, current evidence base, and organisation documentation. Work Package 2 was a retrospective study and included; a retrospective analysis of the service’s dataset of CORE outcomes, one-to-one interviews with veterans and service providers, and a survey of past and current users. Work Package 3 was a prospective study following new users for a maximum of 6 months, which included a cost utility analysis including use of the CSRI.Results: A number of interesting themes arose from the components of the service, with each element providing vital triangulation. Two types of users emerged from the findings; those who access the service for the mental health provision and those who attend to receive practical support from attending agencies. The drop in service was seen as a safe haven, and the military-like environment acted as a core mechanism for change. Comparisons with other services, particularly NHS, were favourable. Cost utility analysis found that the service is cost-effective if improvement is maintained for one year.Conclusions: VOS represents a trusted, familiar environment that meets a range of different needs. Despite this, there are areas that require consideration. Findings suggest that one size does not fit all; what works for those who present with psychological or physical need may not work for those who present with practical or social need. What might suit the former is a quieter drop in, with formal psychological assessment, risk monitoring, and where onward referral is efficient. The power of the military-like environment comes to the fore here as a mechanism. What suits the latter is a busier drop in, with no psychological assessment, and where agencies and service users can network. Of importance to this group is the efficiency of a ‘one stop shop’. What is important for both is greater privacy afforded to them while at the drop in and, arguably, a more frequent drop in.

AB - Objectives: How best to support veterans is a key question for service providers and policy makers. The objectives of the current study were to evaluate a drop in service for veterans delivered by veterans, in terms of effectiveness and cost-utility.Design: A realist evaluation was used to evaluate the drop in service. Realist evaluations seek to understand what works for whom and in what context, and are traditionally mixed method.Methods: The realist evaluation comprised three Work Packages. Work Package 1 involved the development of the programme theory, based on stakeholder interviews, current evidence base, and organisation documentation. Work Package 2 was a retrospective study and included; a retrospective analysis of the service’s dataset of CORE outcomes, one-to-one interviews with veterans and service providers, and a survey of past and current users. Work Package 3 was a prospective study following new users for a maximum of 6 months, which included a cost utility analysis including use of the CSRI.Results: A number of interesting themes arose from the components of the service, with each element providing vital triangulation. Two types of users emerged from the findings; those who access the service for the mental health provision and those who attend to receive practical support from attending agencies. The drop in service was seen as a safe haven, and the military-like environment acted as a core mechanism for change. Comparisons with other services, particularly NHS, were favourable. Cost utility analysis found that the service is cost-effective if improvement is maintained for one year.Conclusions: VOS represents a trusted, familiar environment that meets a range of different needs. Despite this, there are areas that require consideration. Findings suggest that one size does not fit all; what works for those who present with psychological or physical need may not work for those who present with practical or social need. What might suit the former is a quieter drop in, with formal psychological assessment, risk monitoring, and where onward referral is efficient. The power of the military-like environment comes to the fore here as a mechanism. What suits the latter is a busier drop in, with no psychological assessment, and where agencies and service users can network. Of importance to this group is the efficiency of a ‘one stop shop’. What is important for both is greater privacy afforded to them while at the drop in and, arguably, a more frequent drop in.

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Burnell K, Collins E, Gordon K, Hadziosmanovic E, Leonard A, Penney C. A Realist Evaluation of a Voluntary Sector Drop In Service for Veterans. 2018.