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AJPH First Look, published online ahead of print Aug 30, 2005
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95/10/1760    most recent
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October 2005, Vol 95, No. 10 | American Journal of Public Health 1760-1766
© 2005 American Public Health Association
DOI: 10.2105/AJPH.2005.064402


RESEARCH AND PRACTICE

Capturing Intervention Effects Over Time: Reanalysis of a Critical Time Intervention for Homeless Mentally Ill Men

Mary Clare Lennon, PhD, William McAllister, PhD, Li Kuang, MA and Daniel B. Herman, DSW

Mary Clare Lennon, Li Kuang, and Daniel Herman are with the Mailman School of Public Health, Columbia University, New York, NY. Daniel Herman is also with the New York State Psychiatric Institute, New York, NY. William McAllister is with the Institute for Social and Economic Research and Policy, Columbia University.

Correspondence: Requests for reprints should be sent to Mary Clare Lennon, Mailman School of Public Health, Columbia University, Department of Sociomedical Sciences, 722 W 168th St, 9th floor, New York, NY 10032 (e-mail: mcl3{at}columbia.edu).

Objectives. We analyzed whether a method for identifying latent trajectories—latent class growth analysis (LCGA)—was useful for understanding outcomes for individuals subject to an intervention.

Methods. We used LCGA to reanalyze data from a published study of mentally ill homeless men in a critical time intervention (CTI) program. In that study, 96 men leaving a shelter’s onsite psychiatric program were randomly assigned to experimental and control groups. The former received CTI services and the latter usual services. Each individual’s housing circumstances were observed for 18 months after program initiation. Our outcome measure was monthly homelessness: a person was considered homeless in a month if he was homeless for even 1 night that month.

Results. Four latent classes were found among the control group, but just 3 among the experimental group. Control, but not experimental, group individuals showed a small class of chronically homeless men. The size of the never-homeless class was 19 percentage points larger for the experimental than for the control group. J- and inverted-U-shaped patterns were also found among both groups, but with important differences in timing of patterns.

Conclusions. Our results reveal effects not apparent in the original analysis, suggesting that latent class growth models improve intervention evaluation.




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[Abstract] [Full Text] [PDF]




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