Program Evaluation: Entre Familia

Entre Familia: Program Description  Gender- and culture-specific residential treatment program (6 to 12 months duration, located in Mattapan, MA) for substance abuse with co-occurring mental health disorders  Target population: pregnant and postpartum Latina women and their children from metropolitan Boston  Bilingual and bicultural clinical treatment and support services  Family-centered model of care with services based on a bio-psycho-social trauma-informed model for the treatment of addiction  Funding sources include the Boston Public Health Commission (BPHC), the federally funded Boston Consortium of Services for Latino Families in Recovery (BCSLFR), and

Entre Familia: Output Activities  Core clinical treatment services: screening, assessment, referrals to medical and mental health services, residential care, comprehensive case management, childcare services, and referrals for specialized services to address developmental and behavioral difficulties and early intervention  Clinical support services: enhanced case management, individual family treatment planning, and case coordination of services for children  BCSLFR-funded activities: family strengthening activities designed to increase family functioning and build social support networks by engaging the fathers of the children, the partners of the women, and extended family members in treatment

Logic Model

Needs Assessment: BCSLFR-funded activities  Does engaging the fathers of the children, partners of the women, and extended family members in the treatment process help to increase family functioning and to build social support networks?  Process evaluation: survey  Does increased family functioning and stronger social support networks help clients abstain from drug use after treatment program completion?  Outcome evaluation: interview

Process Evaluation  Does engaging the fathers of the children, partners of the women, and extended family members in the treatment process help to increase family functioning and to build social support networks?  Sampling: All women who enter the program during a 6 month period  Inclusion criteria: All women will be included, regardless of whether or not they plan to participate in family strengthening activities  Reasoning: The stigma associated with substance abuse and mental illness in the Latino community can make it difficult for families to support women who face these challenges  Want to identify whether or not this activity is beneficial  Compare before-and-after of the women’s perception of these relationships for both women who participated  Compare before-and-after differences between women who chose to participate in family strengthening activities and the women who did not

Process Evaluation: Methods  Data collection method: surveys  Self-reported relationship with family member  Trust  Open and honest communication  Family member more accepting of the women’s challenge with substance abuse and mental illness  Supportive of women’s effort to seek treatment  Measures agreement with a statement on a scale of 1 to 5  Quantitative analysis  Before and after for women who did family strengthening activities  Before and after for women who did not do activities  Comparison of before surveys for women who did activities and women who did not

Outcome Evaluation  Does increased family functioning and stronger social support networks help clients abstain from drug use after treatment program completion?  Sampling: Women who have left the program during the past 6 months to 1 year  Inclusion criteria: Women who participated in the family strengthening activities while in the residential treatment program, have successfully completed their stay in the residential program, and continue to work with their case managers 6 months later  Reasoning: The family-strengthening activities are BCSLFR-funded, and it is important to makes sure that the activities are worth the resources (time, staff, financial cost, etc.)  Do the women feel that they benefitted from the family strengthening activities?  Do the women feel that their families benefitted from the activities?

Outcome Evaluation: Methods  Data collection method: interviews  One-on-one interview when the women come in to see their case managers  Focus on perceived benefits of the family strengthening activities  Have they abstained from substance use?  Improved relationship with father of child, with partner, with family members  Does their ability to/to not abstain from substance relate to their “strengthened relationships”?  Open ended interview questions  Qualitative analysis  Overall, do the women who participated in the family strengthening activities feel that it benefitted their relationships?  Do the women feel that these strengthened relationships help them abstain from substance use  What aspects of the activities were beneficial, which ones were not helpful?

Discussion: Anticipated Results  Process Evaluation  Women who participated in family strengthening activities reported improved relationships and increased feeling of support  Women who did not participate in family strengthening activities did not report any change in relationships  No initial difference between women who did and did not participate in activities  Outcome Evaluation  Women have increased support from family, partner, father of child  Stronger relationships helps prevent women from relapsing

Discussion: Future Steps  Family strengthening activities should be adapted into treatment programs:  Helps women during their recovery process  Reduces the likelihood of relapse after completion of treatment program  Resource investment (time, staff, financial) is outweighed by benefits of a positive outcome  Ensure future funding for family strengthening activities: BPHC funds activities directly (currently these activities rely on the federally-funded BCSLFR)