In North America, the recent increase in opioid-related deaths has highlighted a need to consult people with Opioid Use Disorder (OUD) on how to improve treatments, namely in terms of service access and patient retention. The aim of this study is to explore experiential perspectives on how to improve accessibility and retention in OUD treatments. Four focus groups were conducted with a total of 27 people with former or current OUD, from treatment programs and community organizations located in Montreal, Canada. A thematic analysis was carried out based on Paill e and Mucchielli'sprocedure, and yielded the following main themes: outreach, flexibility, treatment opportunities, quality of life, comprehensive services, relationship with caregivers and autonomy. These findings provide interesting avenues for policy makers, program administrators and healthcare workers, and may help improving treatment access and retention.
L’équipe de recherche a évalué un projet pilote visant l’insertion professionnelle de personnes ayant un trouble envahissant du développement (TED). Au terme du projet de 36 mois, 29 % des 45 participants occupaient un emploi rémunéré, souvent au-delà du salaire minimum. L’analyse des données a permis de constater que les méthodes d’intervention ont évolué en cours de projet, que plusieurs objectifs ont été atteints, mais que le rodage du modèle n’a pas été possible. L’analyse des processus a permis de cerner les enjeux d’une dynamique partenariale ainsi que ceux associés aux intérêts politiques en contexte d’expérimentation. Dans l’ensemble, le projet a servi à mieux cerner les critères d’une intégration en emploi réussie et à saisir comment s’élaborent des services et programmes d’insertion.We evaluated a pilot project designed to integrate people with Pervasive Developmental Disorder (PDD) into employment. At the end of the 36-month project, 29 % of the 45 participants were employed, often above the minimum wage. Our evaluation showed that methods of intervention endured a tedious trial and error process, which helped participants in terms of some apprenticeships but the evaluation did not achieve testing a full-fledged model. By analyzing the processes, we were able to highlight certain challenges in terms of partnership as well as important stakes in terms of political strategies. Overall, the project gave us an opportunity to gather some evidence as to what might be seen as important criteria for successful job integration for people with PDD and how policy and programs are being built
Co‐occurring disorders in mental health and addiction present a high prevalence, but services available to prevent and treat them are often fragmented. Cross‐training activities have been used to help minimise breaks in service continuity. This study assesses to what extent positional clarification (a specific type of cross‐training activity) can help bridge fragmented services for co‐occurring disorders by providing information and promoting interactions to help professionals better orient and treat their clientele. A total of 2,107 participations were recorded for 11 positional clarification events taking place within the Montreal Cross‐Training Program for mental health and substance use disorders between 2010 and 2016. The Kirkpatrick four‐level training evaluation model was used to evaluate these activities. Evaluation questionnaires (n = 1,650) and interviews with a convenience sample of 32 participants were analysed using descriptive statistics and thematic analysis. More than three‐quarters of participants reported that the activity met their expectations and was relevant to their practice. Respondents also reported receiving useful information to better orient their clientele, discovering new resources, learning about the functioning of other resources, identifying members of other networks who could orient them when needed, and learning more about the theme of the activity and the different mechanisms for collaboration among the related services. Among those who participated in more than one positional clarification event, roughly three‐quarters reported that they were able to call upon new resources at least once as a result of their participation, and were able to establish referrals towards resources that were unknown or less familiar to them prior to their participation. Results suggest that the programme meets its service integration objectives and that positional clarification events can lead to changes that can help facilitate the integration of fragmented services by improving participants' knowledge of specific themes and available resources to better orient and treat their clientele.
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