Astrid Brousselle

Using Logic Analysis to Evaluate Knowledge Transfer Initiatives: The Case of the Research Collective on the Organization of Primary Care Services

Models that shift more responsibility onto researchers for the process of incorporating research results into decision-making have greatly gained in popularity during the past two decades. This shift has created a new area of research to identify the best ways to transfer academic results into the organizational and political arenas. However, evaluating the utilization of information coming out of a knowledge transfer (KT) initiative remains an enormous challenge. This article demonstrates how logic analysis has proven to be a useful evaluation method to assess the utilization potential of KT initiatives. We present the case of the evaluation of the Research Collective on the Organization of Primary Care Services, an innovative experiment in knowledge synthesis and transfer. The conclusions focus not only on the utilization potential of results coming out of the Research Collective, but also on the theoretical framework used, in order to facilitate its application to the evaluation of other knowledge transfer initiatives.

Use of health care services by patients with co-occurring severe mental illness and substance use disorders

BACKGROUNDnTo better respond to the health care needs of people with co-occurring mental illness and substance use disorders, it is vital to understand their itinerary through the health care system.nnnAIMnTo describe the characteristics of service utilization among patients with co-occurring disorders in a large urban area.nnnMETHODnWe used a sample (n = 5467) constituted from administrative and clinical databases. Those identified as having substance use disorders and psychoses were followed over 12 months with respect to their utilization of medical services. A descriptive analysis of the data and a two-step cluster analysis were undertaken.nnnRESULTSnOur analyses revealed a relatively high utilization of emergency services, outpatient clinics, private practices and hospitalization among patients with co-occurring disorders of severe mental illness and substance use. The two-step cluster analysis produced four heterogeneous groups in terms of service utilization.nnnCONCLUSIONSnThis study demonstrates the need to develop strategies for organizing health care and services that are adapted to various sites of service utilization and to diverse profiles of patients with co-occurring mental illness and substance use disorders.

Evaluating Service Organization Models The Relevance and Methodological Challenges of a Configurational Approach

Based on the example of the evaluation of service organization models, this article shows how a configurational approach overcomes the limits of traditional methods which for the most part have studied the individual components of various models considered independently of one another. These traditional methods have led to results (observed effects) that are difficult to interpret. The configurational approach, in contrast, is based on the hypothesis that effects are associated with a set of internally coherent model features that form various configurations. These configurations, like their effects, are context-dependent. We explore the theoretical basis of the configuration approach in order to emphasize its relevance, and discuss the methodological challenges inherent in the application of this approach through an in-depth analysis of the scientific literature. We also propose methodological solutions to these challenges. We illustrate from an example how a configurational approach has been used to evaluate primary care models. Finally, we begin a discussion on the implications of this new evaluation approach for the scientific and decision-making communities.