Support and Services at Home (SASH) Evaluation: First Annual Report. APPENDIX B: Qualitative Data and Methods


B.1. Annual Site Visits

The RTI International/LeadingAge CAR team conducted a site visit of four SASH panels over a three-day period in February 2013. The purpose of the site visits was to understand the SASH program implementation and operation, implementation/operation successes and challenges, and perceived impacts on program participants, SASH providers and partners and the state's MAPCP Demonstration.

The visits were conducted by two two-person teams and each team visited two SASH panels. At the time of the visits, 26.5 panels were operating around the state. The team prioritized selecting a mix of panels operating in different environments to provide insight on how the program worked in varying contexts. Several factors were considered, including:

  • Panel location (urban/rural, different areas of state).

  • Type of housing properties in the panel (public housing, subsidized [HUD, Rural Development, LIHTC, state], mobile home park).

  • Number of housing sites SASH coordinator/wellness nurse responsible for in the panel (one versus multiple).

  • Number/proportion of community dwelling participants in the panel.

  • Maturity of CHT in the panel's region.

  • Anything exceptional about the SASH team's interaction with the CHT.

  • Anything exceptional about composition of the SASH team.

  • Roll-out date of the SASH panel.

In each panel, one-on-one interviews were conducted with a range of stakeholders involved with the panel. Interviewees included the SASH Coordinator, SASH Wellness Nurse, representatives from organizations participating on the SASH team, CHT representatives, housing property managers, and the executive director of the DRHO for the region in which the panel is located.

Protocols were developed by RTI/CAR and reviewed by ASPE/HUD. The protocols were designed to help understand the facilitators and barriers to program implementation and operations, the perceived impact on program participants and the property and service providers, and the possibilities for sustainability and replicability in other locations. Interview protocols were tailored to specific respondent types.

Due to limitations on the number of individuals within a stakeholder category that can be interviewed without triggering a review by the U.S. Office of Management and Budget (OMB), the teams were not able to interview all representatives of each SASH Team. However, the team did conduct interviews with representatives from each of the types of organizations represented on the team (home health agency, area agency on aging or mental health agency) to make sure the different organizational perspectives were captured.

Interview lengths ranged 1-2 hours depending on the type of respondent:

  1. CHT staff (1 hour).

  2. DRHO staff (1 hour).

  3. Property managers (1 hour).

  4. SASH coordinators (1.5-2 hours).

  5. SASH wellness nurses (1.5-2 hours).

  6. Community service providers (home health agency, area agency on aging, etc.) (1 hour).

The first round of site visits were conducted without OMB approval, thus, we were very careful to limit our interviewing to no more than nine interviews per type of respondent. For subsequent rounds of sites visits, we will develop a Paperwork Reduction Act package for submission to OMB. We believe that we will need to secure OMB approval before the site visits in the second year, as the aggregate number of respondents by respondent type will exceed nine.

For the first site visit report, RTI/CAR produced a high level summary of findings to address key research questions and highlight the key issues identified during the particular site visit. In future site visit reports, notes and other information gathered from the interviews will be coded and entered in a qualitative data base, NVivo 10 (, for more in-depth analysis.

B.2. Quarterly Conference Calls

The RTI/LeadingAge team held four quarterly conference calls with SASH staff and the Contracting Officer's Representative (COR) during the first year of evaluation. The primary purpose of the quarterly calls was to understand the details of program implementation and operation, monitor implementation progress, and identify implementation and operational successes and challenges as the SASH program is expanded statewide and matures. The quarterly calls helped inform the evaluation team on areas of investigation for the annual site visits.

Each call was organized around the following structure:

  • An update on the current status of implementation, including the number of existing panels and participants and any planned new panels.

  • An update of any significant changes, challenges or success regarding program implementation.

  • An in-depth discussion of a specific program implementation or operational element.

In year one, the following four topical areas were discussed:

  • General background and organizational structure of the SASH program.

  • Funding and financing mechanisms for SASH program.

  • Start-up of new SASH panels.

  • Data collection and information technology (DocSite and clinical registry).

The calls were conducted with the appropriate SASH staff depending on the focused topic of the call. Staff included the CSC SASH program staff for the first year of the evaluation. A discussion guide was created for each quarterly call. The guide was sent to the COR for review and input and then forwarded to the SASH program staff prior to the call to allow them to prepare any necessary information or data.

The topical areas for years two and three will be identified based on priority issues identified in previous quarterly calls, the annual site visits and the quantitative data analysis that the team believes it needs to gain a greater understanding of. Examples of potential topical areas could include: serving community-based SASH participants (versus property residents), addressing mental health needs (or other special needs), engagement with CHTs and other health providers, and working with community-based partners (SASH interdisciplinary team).

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