Paula Goering
Datos Biográficos
| ID | 383044 |
|---|---|
| NOMBRE | Paula Goering |
| NOMBRES | Paula |
| APELLIDO | Goering |
| FIRMA | GOERING P |
| AFILIACIONES | Centre for Addiction and Mental Health |
| ORCID | 0000-0002-2976-2127 |
| VERIFICADO | Sí |
| TOTAL DE OBRAS | 43 |
| TOTAL DE CITAS | 189 |
| TOTAL COMO AUTOR | 43 |
| TOTAL COMO EDITOR | 0 |
| PRIMER AÑO DE PUBLICACIÓN | 1987 |
| AÑO MÁS RECIENTE DE PUBLICACIÓN | 2020 |
| ÍNDICE H | 8 |
Indigenous and non‐Indigenous parents separated from their children and experiencing homelessness and mental illness in Canada
The purpose of this study is to examine the parent-child experiences of Indigenous and non-Indigenous mothers and fathers experiencing homelessness, mental illness, and separation from their children. A qualitative thematic analysis of baseline and 18-month follow-up narrative interviews was used to compare 12 mothers (n = 8 Indigenous and n = 4 nonindigenous) with 24 fathers (n = 13 Indigenous and n = 11 non-Indigenous). First, it was found that…
A randomized controlled trial of the effectiveness of Housing First in a small Canadian City
International Standard Randomized Control Trial Number Register Identifier: ISRCTN42520374 , assigned August 18, 2009
Systems change in the context of an initiative to scale up Housing First in Canada
In this study, we examine changes in the homeless‐serving system in the context of a training and technical assistance initiative to scale up Housing First (HF) in 6 Canadian communities. Based on qualitative data from focus groups and individual interviews with key stakeholders (k = 7, n = 35) and field notes gathered over a 3‐year period (n = 146), we found 2 main system changes: (a) changes in the capacity of the service delivery system at mul…
Understanding Systems Change in Early Implementation of Housing First in Canadian Communities
We present interim findings of a cross‐site case study of an initiative to expand Housing First ( HF ) in Canada through training and technical assistance ( TTA ). HF is an evidence‐based practice designed to end chronic homelessness for consumers of mental health services. We draw upon concepts from implementation science and systems change theory to examine how early implementation occurs within a system. Case studies examining HF early impleme…
Navigating Complex Implementation Contexts
Highlights Housing First can be implemented beyond demonstration sites without new resources. Using an intentional implementation strategy communities implemented high‐fidelity programs. One key implementation challenge was accessing affordable housing and housing subsidies. By helping develop housing specialists and reflective practice, the TTA facilitated effective implementation
What Happens After the Demonstration Phase? The Sustainability of Canada's At Home/Chez Soi Housing First Programs for Homeless Persons with Mental Illness
This research examined the sustainability of Canada's At Home/Chez Soi Housing First ( HF ) programs for homeless persons with mental illness 2 years after the end of the demonstration phase of a large (more than 2000 participants enrolled), five‐site, randomized controlled trial. Qualitative interviews were conducted with 142 participants (key informants, HF staff, and persons with lived experience) to understand sustainability outcomes and fact…
A Multiple-City RCT of Housing First With Assertive Community Treatment for Homeless Canadians With Serious Mental Illness
OBJECTIVE: Housing First with assertive community treatment (ACT) is a promising approach to assist people with serious mental illness to exit homelessness. The article presents two-year findings from a multisite trial on the effectiveness of Housing First with ACT. METHODS: The study design was a randomized controlled trial conducted in five Canadian cities. A sample of 950 participants with serious mental illness who were absolutely homeless or…
Housing Quality in a Randomized Controlled Trial of Housing First for Homeless Individuals with Mental Illness
Housing quality (HQ) is associated with mental health, and may mediate outcomes in housing interventions. However, studies of housing interventions rarely report HQ. The purpose of this study was to describe HQ in a multi-site randomized controlled trial of Housing First (HF) in five Canadian cities and to examine possible differences by treatment group (HF recipients and treatment-as-usual (TAU) participants who were able to find housing through…
Effect of Scattered-Site Housing Using Rent Supplements and Intensive Case Management on Housing Stability Among Homeless Adults With Mental Illness
Importance Scattered-site housing with Intensive Case Management (ICM) may be an appropriate and less-costly option for homeless adults with mental illness who do not require the treatment intensity of Assertive Community Treatment. Objective To examine the effect of scattered-site housing with ICM services on housing stability and generic quality of life among homeless adults with mental illness and moderate support needs for mental health servi…
Collaboration and involvement of persons with lived experience in planning Canada's At Home/Chez Soi project
Planning the implementation of evidence-based mental health services entails commitment to both rigour and community relevance, which entails navigating the challenges of collaboration between professionals and community members in a planning environment which is neither 'top-down' nor 'bottom-up'. This research focused on collaboration among different stakeholders (e.g. researchers, service-providers, persons with lived experience [PWLE]) at fiv…
Implementing Housing First Across Sites and Over Time
This article examines later fidelity and implementation of a five‐site pan‐Canadian Housing First research demonstration project. The average fidelity score across five Housing First domains and 10 programs was high in the first year of operation (3.47/4) and higher in the third year of operation (3.62/4). Qualitative interviews (36 key informant interviews and 17 focus groups) revealed that staff expertise, partnerships with other services, and …
Pathways into homelessness
This qualitative study examined how homeless individuals with mental illness experience pathways into homelessness. Study participants were enrolled in the At Home/Chez Soi project, a Pan-Canadian Randomized Controlled Trial comparing the Housing First approach with Treatment as Usual for homeless individuals. This inquiry is grounded in social ecological perspective, which considers interactions between individual and structural factors. Finding…
Development and Initial Validation of the Observer-Rated Housing Quality Scale (OHQS) in a Multisite Trial of Housing First
Le rôle des familles de personnes en situation d’itinérance et souffrant de troubles mentaux
Cet article s’intéresse à l’expérience des familles qui soutiennent un proche en situation d’itinérance et souffrant de troubles mentaux. Les auteurs explorent les types de soutien offerts par les familles ; ils examinent aussi les dimensions relationnelles et personnelles qui peuvent soutenir une redéfinition des rôles et une modulation du niveau de soutien. Utilisant un devis qualitatif, des entretiens semi-dirigés ont été réalisés auprès de 14…
Planning a Multi‐site, Complex Intervention for Homeless People with Mental Illness
This research focused on the relationships between a national team and five project sites across Canada in planning a complex, community intervention for homeless people with mental illness called At Home/Chez Soi, which is based on the Housing First model. The research addressed two questions: (a) what are the challenges in planning? and (b) what factors that helped or hindered moving project planning forward? Using qualitative methods, 149 nati…
Bringing politics and evidence together
Exploring the Value of Mixed Methods Within the At Home/Chez Soi Housing First Project
The At Home/Chez Soi trial protocol
Introduction Housing First is a complex housing and support intervention for homeless individuals with mental health problems. It has a sufficient knowledge base and interest to warrant a test of wide-scale implementation in various settings. This protocol describes the quantitative design of a Canadian five city, $110 million demonstration project and provides the rationale for key scientific decisions. Methods A pragmatic, mixed methods, multi-…
Cognitive Interviewing Methods for Questionnaire Pre-Testing in Homeless Persons with Mental Disorders
Organizational analysis of Canadian supported employment programs for people with psychiatric disabilities
Developing a guide to support the knowledge translation component of the grant application process
Research funding agencies often expect that grant applications include a knowledge translation (KT) plan but many applicants and reviewers are without any clear idea of how to develop or assess such a plan. This paper arises from the development of a guide to support the KT component of the research grant application process. The authors reflect on some of the controversial issues related to KT definitions and scope that they struggled with as th…
A Pan-Canadian Evaluation of Supported Employment Programs Dedicated to People with Severe Mental Disorders
Health Care Cost Matters for Homeless People
Mental health service delivery in Ontario, Canada
Like many jurisdictions, mental health policy-making in Ontario, Canada, has a long history of frustrated attempts to move from a hospital and physician-based tradition to a coordinated system with greater emphasis on community-based mental health care. This study examines policy legacies associated with the introduction of psychiatric hospitals in the 1850s and of public health insurance (medicare) in the 1960s in Ontario; and their effect on su…
A longitudinal study of mental health consumer/survivor initiatives
The objective of this study was to evaluate the impacts of participation in mental health Consumer/Survivor Initiatives (CSIs), organizations run by and for people with mental illness. A nonequivalent comparison group design was used to compare three groups of participants: (a) those who were continually active in CSIs over a 36‐month period (n = 25); (b) those who had been active in CSIs at 9‐ and 18‐month follow‐up periods, but who were no long…
Organizational Factors that Influence University-Based Researchers’ Engagement in Knowledge Transfer Activities
Knowledge transfer has become a priority for universities and other publicly funded research institutions. However, researchers working in these settings report certain structural barriers to engaging in knowledge translation activities. This article describes these barriers, situating them in the disjunction between current expectations and the historical tradition of disciplinary authority in academia. The authors review some of the organizatio…
Pathways into homelessness
This qualitative study examined how homeless individuals with mental illness experience pathways into homelessness. Study participants were enrolled in the At Home/Chez Soi project, a Pan-Canadian Randomized Controlled Trial comparing the Housing First approach with Treatment as Usual for homeless individuals. This inquiry is grounded in social ecological perspective, which considers interactions between individual and structural factors. Finding…
Implementing Housing First Across Sites and Over Time
This article examines later fidelity and implementation of a five‐site pan‐Canadian Housing First research demonstration project. The average fidelity score across five Housing First domains and 10 programs was high in the first year of operation (3.47/4) and higher in the third year of operation (3.62/4). Qualitative interviews (36 key informant interviews and 17 focus groups) revealed that staff expertise, partnerships with other services, and …
Gender and outpatient mental health service use
A Pan-Canadian Evaluation of Supported Employment Programs Dedicated to People with Severe Mental Disorders
Bringing politics and evidence together
Planning a Multi‐site, Complex Intervention for Homeless People with Mental Illness
This research focused on the relationships between a national team and five project sites across Canada in planning a complex, community intervention for homeless people with mental illness called At Home/Chez Soi, which is based on the Housing First model. The research addressed two questions: (a) what are the challenges in planning? and (b) what factors that helped or hindered moving project planning forward? Using qualitative methods, 149 nati…
Understanding Systems Change in Early Implementation of Housing First in Canadian Communities
We present interim findings of a cross‐site case study of an initiative to expand Housing First ( HF ) in Canada through training and technical assistance ( TTA ). HF is an evidence‐based practice designed to end chronic homelessness for consumers of mental health services. We draw upon concepts from implementation science and systems change theory to examine how early implementation occurs within a system. Case studies examining HF early impleme…
What Happens After the Demonstration Phase? The Sustainability of Canada's At Home/Chez Soi Housing First Programs for Homeless Persons with Mental Illness
This research examined the sustainability of Canada's At Home/Chez Soi Housing First ( HF ) programs for homeless persons with mental illness 2 years after the end of the demonstration phase of a large (more than 2000 participants enrolled), five‐site, randomized controlled trial. Qualitative interviews were conducted with 142 participants (key informants, HF staff, and persons with lived experience) to understand sustainability outcomes and fact…
Exploring the Value of Mixed Methods Within the At Home/Chez Soi Housing First Project
Social networks of residents in supportive housing
Housing Quality in a Randomized Controlled Trial of Housing First for Homeless Individuals with Mental Illness
Housing quality (HQ) is associated with mental health, and may mediate outcomes in housing interventions. However, studies of housing interventions rarely report HQ. The purpose of this study was to describe HQ in a multi-site randomized controlled trial of Housing First (HF) in five Canadian cities and to examine possible differences by treatment group (HF recipients and treatment-as-usual (TAU) participants who were able to find housing through…
The mental health of informal caregivers in Ontario
OBJECTIVES: This study describes the mental health status, disability, physical health, and mental health service utilization of informal care-givers under the age of 65 in the province of Ontario. METHODS: The study analyzed data collected in the 1991 province-wide, population-based mental health supplement to the Ontario Health Survey. Diagnoses from the Diagnostic and Statistical Manual of Mental Disorders, 3rd edition, revised, were generated…
Systems change in the context of an initiative to scale up Housing First in Canada
In this study, we examine changes in the homeless‐serving system in the context of a training and technical assistance initiative to scale up Housing First (HF) in 6 Canadian communities. Based on qualitative data from focus groups and individual interviews with key stakeholders (k = 7, n = 35) and field notes gathered over a 3‐year period (n = 146), we found 2 main system changes: (a) changes in the capacity of the service delivery system at mul…
Considering a multisite study? How to take the leap and have a soft landing
Although most policymakers agree that a fundamental goal of the mental health system is to provide integrated community‐based services, there is little empirical evidence with which to plan such a system. Studies in the community mental health literature have not used a standard set of evaluation methods. One way of addressing this gap is through a multisite program evaluation in which multiple sites and programs evaluate the same outcomes using …
Navigating Complex Implementation Contexts
Highlights Housing First can be implemented beyond demonstration sites without new resources. Using an intentional implementation strategy communities implemented high‐fidelity programs. One key implementation challenge was accessing affordable housing and housing subsidies. By helping develop housing specialists and reflective practice, the TTA facilitated effective implementation
A longitudinal study of mental health consumer/survivor initiatives
The objective of this study was to evaluate the impacts of participation in mental health Consumer/Survivor Initiatives (CSIs), organizations run by and for people with mental illness. A nonequivalent comparison group design was used to compare three groups of participants: (a) those who were continually active in CSIs over a 36‐month period (n = 25); (b) those who had been active in CSIs at 9‐ and 18‐month follow‐up periods, but who were no long…
Collaboration and involvement of persons with lived experience in planning Canada's At Home/Chez Soi project
Planning the implementation of evidence-based mental health services entails commitment to both rigour and community relevance, which entails navigating the challenges of collaboration between professionals and community members in a planning environment which is neither 'top-down' nor 'bottom-up'. This research focused on collaboration among different stakeholders (e.g. researchers, service-providers, persons with lived experience [PWLE]) at fiv…
Cognitive Interviewing Methods for Questionnaire Pre-Testing in Homeless Persons with Mental Disorders
Organizational analysis of Canadian supported employment programs for people with psychiatric disabilities
Credibility and credibility work in knowledge transfer
English This study explores the dimensions and attributes of credibility in knowledge transfer. It finds that there are four dimensions: ‘scientific credibility’, expertise, authority and stance. Credibility is characterised by several attributes: it is transferable; it is context-dependent; and it is subject to constant assessment. The notion of ‘credibility work’ describes the ways in which credibility in knowledge transfer is not an inherent o…
A Home-Based Program for the Treatment of Acute Psychosis
Development and Initial Validation of the Observer-Rated Housing Quality Scale (OHQS) in a Multisite Trial of Housing First
Clinical issues in social network therapy for clients with schizophrenia
Teaching clinical research
Clinicians are well suited in many ways to conducting research, but appropriate training and support must be provided. A series of multidisciplinary workshops designed to facilitate clinical research are used as a focus for describing common problems and their solutions. Practical means for initiating and assisting clinical research are proposed
Exploring the helping relationship between the schizophrenic client and rehabilitation therapist
This paper argues that the enhanced efficacy of current rehabilitation strategies compared to insight-oriented therapies for schizophrenic clients cannot be understood in terms of differences in technique alone. Rather, the relationship that develops between rehabilitation therapist and schizophrenic client may represent a potent therapeutic ingredient warranting further study. The concept of therapeutic alliance is examined as a means toward und…
Supportive Housing
The current debate about how to provide housing for persons with persistent psychiatric disabilities should be informed by empirical information from a variety of sources. Data from a study of 17 residents discharged from Regeneration House Inc., illustrates the value of consumer perceptions in the evaluation of supportive housing. Extensive exploration of the positive and negative aspects of living in a group home from the perspective of experie…
Clinical issues in social network therapy for clients with schizophrenia
Social networks of residents in supportive housing
The mental health of informal caregivers in Ontario
OBJECTIVES: This study describes the mental health status, disability, physical health, and mental health service utilization of informal care-givers under the age of 65 in the province of Ontario. METHODS: The study analyzed data collected in the 1991 province-wide, population-based mental health supplement to the Ontario Health Survey. Diagnoses from the Diagnostic and Statistical Manual of Mental Disorders, 3rd edition, revised, were generated…
Process and outcome in a hostel outreach program for homeless clients with severe mental illness
A longitudinal study followed 55 homeless and severely mentally ill clients of a hostel outreach program to assess outcomes and their relationship to program elements. Results at 18-month follow-up indicated that, despite chronic histories of transiency and shelter use, housing stability had been achieved, and that initial gains in social functioning and symptom reduction had been increased. Development of a strong working alliance proved a key p…
A Home-Based Program for the Treatment of Acute Psychosis
Physical Health Complaints and the Use of Outpatient Mental Health Services Among Those with a Mental Disorder
Psychiatric Morbidity and Physician Visits
OBJECTIVES: The authors examine the association between psychiatric morbidity and visits to general practitioners and family practitioners in Ontario, Canada. METHODS: A nested set of hypotheses were posed to account for different levels of use among persons with differing levels of psychiatric morbidity. The sample of 8,116 is drawn from a comprehensive household survey of physical and mental health that included the UM-CIDI standardized diagnos…
Classifying Psychiatric Inpatients
BACKGROUND: Use of case-mix reimbursement in psychiatric inpatients has been limited as a result of a lack of systems which effectively group patients according to required resource needs. In recognition of the fact that many patient factors, in addition to diagnosis influence delivery of care in psychiatry, new measures of patient need are emerging. OBJECTIVE: This study compared improvement realized by using a multidimensional measure of patien…
Narratives of Identity
The problem of homelessness is a pressing social and health concern ascribed to the interaction between personal, social, economic, and service system resources. This article is based on a qualitative study of the experiences of 29 homeless individuals. In-depth interviews were conducted with single adult shelter users. Analysis revealed the self to be a process that was continually developing. Participants tacitly locate their self-concepts in t…
Considering a multisite study? How to take the leap and have a soft landing
Although most policymakers agree that a fundamental goal of the mental health system is to provide integrated community‐based services, there is little empirical evidence with which to plan such a system. Studies in the community mental health literature have not used a standard set of evaluation methods. One way of addressing this gap is through a multisite program evaluation in which multiple sites and programs evaluate the same outcomes using …
Gender and outpatient mental health service use
Organizational Factors that Influence University-Based Researchers’ Engagement in Knowledge Transfer Activities
Knowledge transfer has become a priority for universities and other publicly funded research institutions. However, researchers working in these settings report certain structural barriers to engaging in knowledge translation activities. This article describes these barriers, situating them in the disjunction between current expectations and the historical tradition of disciplinary authority in academia. The authors review some of the organizatio…
No Matter How You Land
In an earlier article, we described the mindset and process for implementing and conducting a multi-site study. In this article, we take the perspective of the multi-site study’s coordinating centre. Using the Community Mental Health Evaluation Initiative as a case study, we focus on four major aspects of the initiative — data collection and management, the evaluated programs, partnerships, and knowledge transfer. We discuss a variety of challeng…
Credibility and credibility work in knowledge transfer
English This study explores the dimensions and attributes of credibility in knowledge transfer. It finds that there are four dimensions: ‘scientific credibility’, expertise, authority and stance. Credibility is characterised by several attributes: it is transferable; it is context-dependent; and it is subject to constant assessment. The notion of ‘credibility work’ describes the ways in which credibility in knowledge transfer is not an inherent o…
Who uses consumer-run self-help organizations
A multisite evaluation of community mental health services is used to answer two questions: (a) How do diagnosis, functioning, and self-assessments of consumer/survivor initiative (CSI) and assertive community treatment (ACT) participants compare?, and (b) What other supports/services are CSI and ACT participants using? The sample is from an Ontario evaluation of consumer/survivor peer initiatives in four communities (n=73). The reference group i…
Mental health service delivery in Ontario, Canada
Like many jurisdictions, mental health policy-making in Ontario, Canada, has a long history of frustrated attempts to move from a hospital and physician-based tradition to a coordinated system with greater emphasis on community-based mental health care. This study examines policy legacies associated with the introduction of psychiatric hospitals in the 1850s and of public health insurance (medicare) in the 1960s in Ontario; and their effect on su…
A longitudinal study of mental health consumer/survivor initiatives
The objective of this study was to evaluate the impacts of participation in mental health Consumer/Survivor Initiatives (CSIs), organizations run by and for people with mental illness. A nonequivalent comparison group design was used to compare three groups of participants: (a) those who were continually active in CSIs over a 36‐month period (n = 25); (b) those who had been active in CSIs at 9‐ and 18‐month follow‐up periods, but who were no long…
Health Care Cost Matters for Homeless People
A Pan-Canadian Evaluation of Supported Employment Programs Dedicated to People with Severe Mental Disorders
Developing a guide to support the knowledge translation component of the grant application process
Research funding agencies often expect that grant applications include a knowledge translation (KT) plan but many applicants and reviewers are without any clear idea of how to develop or assess such a plan. This paper arises from the development of a guide to support the KT component of the research grant application process. The authors reflect on some of the controversial issues related to KT definitions and scope that they struggled with as th…
The At Home/Chez Soi trial protocol
Introduction Housing First is a complex housing and support intervention for homeless individuals with mental health problems. It has a sufficient knowledge base and interest to warrant a test of wide-scale implementation in various settings. This protocol describes the quantitative design of a Canadian five city, $110 million demonstration project and provides the rationale for key scientific decisions. Methods A pragmatic, mixed methods, multi-…
Cognitive Interviewing Methods for Questionnaire Pre-Testing in Homeless Persons with Mental Disorders
Medicine (33 obras) · Psychiatry (30 obras) · Psychology (29 obras) · Mental health (27 obras) · Homelessness and Social Issues (24 obras) · Political science (19 obras) · Mental illness (18 obras) · Mental Health and Patient Involvement (16 obras) · Sociology (15 obras) · Housing First (13 obras)