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Communimetrics

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Communimetrics is a science for measuring communication and action in human services/social services environments. Founded in a theory of communication, Communimetrics is essentially a measurement theory.[1] It is given its fullest articulation by Dr. John S. Lyons in his book, Communimetrics. Communimetrics is rooted in other measurement theories in human sciences such as cliometrics.[2]

Communimetrics is primarily used in the engineering of social service and mental health systems. Its primary practitioners are people tasked with network and system planning, evaluation, management, and clinical leadership. It is used in government funded behavioral health systems, social services systems like the child welfare system, and accountable care organization environments. Those who score communimetric tools can be of any level of an organization, but they will not always be fully aware of communimetric science, and may just think of themselves as completing a formal biopsychosocial evaluation.

Communimetrics measures[edit]

Communimetrics is used to make assessment tools in human services and mental health environments. Below is a list of the most well known tools, and science related to their use, validity and reliability.

  • The Intermed. the INTERMED is used in hospital settings to sort people to different levels of care: outpatient, specialty care, or complex care.
    • The construct validity of the Intermed's ability to differentiate severity were tested with positive results by de Jong.[3]
    • The development and reliability testing of the INTERMED are discussed by Huyse et all in a 1999 paper.[4]
    • The validity of the INTERMED for clinical use was demonstrated by Stiefel et al in 199.[5]
    • The construct validity of the INTERMED in assigning complexity ratings to patients with low back pain was substantiated by Steifel et al in 1999.[6]
  • The Adult Needs and Strengths Assessment (ANSA). The ANSA is used to measure clinical need and severity of adults in human services and mental health. Like all communimetric tools it can be optimized and tailored for local system needs, but traditionally measures in five domains: Mental Health Needs, Risk Behaviors, Functioning Needs, Caregiver Strengths and Needs, Cultural Strengths and Needs.
    • Schmit et al. (2018) utilized communimetirc data from the ANSA to assess the effectiveness of primary and behavioral health integration.[7]
    • Walton and Kim (2018) demonstrated the construct validity of the ANSA.[8]
  • The Child and Adoelscent Needs and Strengths (CANS[9]). The CANS is the most widely used communimetric tool, with active implementations in all 50 states, and internationally.
    • Cordell, Snowden and Hosier demonstrated the ability of using the CANS to identify patterns and priorities of service need utilizing the CANS.[10]
    • Anderson, Lyons, Giles, Price and Estle (2003) indicate that the CANS is reliable at the domain level.[11]
    • Stoner, Leon, & Fuller (2015) utilized the CANS to predict the reductions of depressive symptoms for children and adolescents in foster care.[12]
    • Almadari & Spanovic-Kelber (2016) established the construct validity of the CANS short-form.[13]
    • The CANS validity as an outcomes tool was presented by Lyons, Weiner and Lyons in 2004.[14]
    • The CANS was successfully used to predict resolution for antisocial behavior among youth in foster care by Dunleavy & Leon in 2011.[15]
    • The CANS has been shown to be able to distinguish treatment benefits between trauma interventions for children. (Bartlett, et al., 2018[16])
    • The CANS was used to identify groups of children benefiting (and not benefiting) from a community based service in Pennsylvania called BHRS. This information was then used to inform decision support for clinicians prescribing the service to youth.[17]
  • ·  Children's Hospital (of Eastern Ontario) Inventory of Skills in Audition, Language and Speech (CHISALS). The CHISALS is a specialty tool for measureing progress in audition.
    • The CHISALS has been shown to be valid in showing progress in audition, language and speech for children.[18]
  • The Family Advocacy and Support Tool (FAST). The FAST is used to ascertain family needs, primarily in child welfare environments.
    • · Weigensberg et al (2018) demonstrated the use of the FAST for identification of superutilization of child welfare, Medicaid, and other services.[19]
    •  The state of New York utilized FAST data to identify differential response in child protective services in New York.[20]
  • The Crisis Assessment Tool (CAT)
  • Readiness Inventory for Successful Entrepreneurship (RISE)
  • Home, Education, Activities & peers, Drugs & Alcohol, Suicidality, Emotions & behaviors, and Discharge Resources (HEADS-ED)

Large Scale Communimetrics implementations[edit]

Large Scale Communimetric Implementations are primarily done through State governments, county governments, or behavioral health managed care organizations. These implementations affect the lives of thousands of children and families, and generate their own documentation. Some of the most important implementations are listed here.

Pennsylvania Behavioral Health Rehabilitation Services[edit]

The CANS is used to track clinical outcomes and provide decision support for children with serious mental illness in Pennsylvania's Behavioral Health Rehabilitation Services program[21]. The program touches thousands of Medicaid families every year.

New York Health Homes Serving Children[edit]

Children with serious mental illness in New York will be served by "Health Homes" that utilize CANS for outcomes tracking and decision support.[22]

Indiana Data Assessment Registry Mental Health & Addiction[edit]

Indiana has a large scale project with ANSA and CANS that touches thousands of Medicaid lives yearly.[23]

Wisconsin foster care[edit]

The Wisconsin foster care system uses the CANS for rate setting.[24]

San Francisco[edit]

San Francisco has developed a computer system, Avatar, that captures CANS data. The information is used for rate setting and tracking outcomes.[25]

New Jersey[edit]

New Jersey's System of Care program relies on CANS for information management decision support.[26]

Magellan Behavioral Health[edit]

The behavioral health managed care entity, Magellan, utilizes the CANS in several contracts including Pennsylvania, Louisiana, Nebraska, and others.[27]

PerformCare[edit]

The behavioral health managed care entity, PerformCare, utilizes the CANS for children, and the ANSA in its adult inpatient program.[28]

Out-of-home care in Singapore[edit]

The Singapore version of the CANS was adapted for the child welfare population by a workgroup consisting of local professionals such as psychologists and social workers from child protection services, in consultation with the developer of the CANS. The Singapore version of the CANS consists of 82 items across seven domains (Life Functioning, School, Behavioral and Emotional Needs, Risk Behavior Needs, Long-term Caregiver and Strengths).[29]

References[edit]

  1. Lyons, John S (2009). Communimetrics: A Communication Theory of Measurement in Human Service Settings. Dordrecht: Springer. ISBN 9780387928210. Search this book on
  2. Lyons, John S; Cain, Louis P; Williamson, Samuel H (2007). Reflections on the Cliometics Revolution: Conversations with Economic Historians. Routledge. ISBN 9781135993597. Search this book on
  3. de Jonge, Ph.D., Peter (March–April 2001). "INTERMED—A Clinical Instrument for Biopsychosocial Assessment". Psychosomatics. 42 (2): 106–109. doi:10.1176/appi.psy.42.2.106. PMID 11239122.
  4. Huyse, Frits (January–February 1999). ""INTERMED": a method to assess health service needs: I. Development and reliability". General Hospital Psychiatry. 21 (1): 39–48. doi:10.1016/S0163-8343(98)00057-7. PMID 10068919.
  5. Sitefel, Frederich (January–February 1999). ""INTERMED": a method to assess health service needs: II. Results on its validity and clinical use". General Hospital Psychiatry. 21:1: 49–56.
  6. Steifel, Friedrich (February 15, 1999). "INTERMED-An Assessment and Classification System for Case Complexity: Results in Patients With Low Back Pain". Spine. 24:4: 378–384.
  7. Schmit, Michael (2018). "Examining the effectiveness of integrated behavioral and primary healthcare treatment". Journal of Counseling & Development. 96: 3–14. doi:10.1002/jcad.12173.
  8. Walton, Betty; Kim, Hea-Won (20 March 2018). "Validating a Behavioral Health Instrument for Adults: Exploratory Factor Analysis". Journal of Social Service Research. 44-Issue 2 (2): 249–265. doi:10.1080/01488376.2018.1442897. hdl:1805/17682.
  9. "The Child and Adolescent Needs and Strengths (CANS) | Praed Foundation". praedfoundation.org. Retrieved 2018-08-08.
  10. Cordell, K.D. (2016). "Patterns and priorities of service need identified through the Child and Adolescent Needs and Strengths (CANS) assessment". Children and Youth Service Review. 60: 129–135. doi:10.1016/j.childyouth.2015.11.020.
  11. Anderson, R.L. (2003). "Reliability of the child and adolescent needs and strengths-mental health (CANS-MH) scale". Journal of Child and Family Studies. 12 (3): 279–289. doi:10.1023/A:1023935726541.
  12. Stoner, A.M. (2015). "Predictors of reduction in symptoms of depression for children and adolescents in foster care". Journal of Child and Family Studies. 24 (3): 784–797. doi:10.1007/s10826-013-9889-9.
  13. Alamdari, Golnar (November 2016). "The Child and Adolescent Needs and Strengths as an Outcome Measure in Community Mental Health: Factor Analysis and a Validation of the Short Form". Community Mental Health Journal. 52 (8): 1118–1122. doi:10.1007/s10597-016-9996-3. PMID 26856323.
  14. Lyons, J.S. (2004). "Measurement as communication in outcomes management: The child and adolescent needs and strengths (CANS)". The Use of Psychological Testing for Treatment Planning and Outcomes Assessment. Volume 2: Instruments for Children and Adolescents. Search this book on
  15. Dunleavy, A.M. (2011). "Predictors for resolution of antisocial behavior among foster care youth receiving community-based services". Children and Youth Services Review. 33 (11): 2347–2354. doi:10.1016/j.childyouth.2011.08.005.
  16. Bartlett, J.D. (2018). "The impact of a statewide trauma-informed care initiative in child welfare on the well-being of children and youth with complex trauma". Children and Youth Services Review. 84: 110–117. doi:10.1016/j.childyouth.2017.11.015.
  17. An Introduction to Community Data Roundtable's Behavioral Health Rehabilitation Services Outcomes Dashboard. Pennsylvania: Community Data Roundtable. 2015. pp. 1–19. Search this book on
  18. Neuss, Deirdre (June 1, 2018). "The Development of the Children's Hospital (of Eastern Ontario) Inventory of Skills in Audition, Language and Speech (CHISALS)". The Volta Review. 117: 1–2.
  19. Weigensberg, Elizabeth (March 29, 2018). Superutilization of Child Welfare, Medicaid, and Other Services. Casey Family Programs: Mathematica Policy Research. pp. 1–246. Search this book on
  20. Differential Response in Child Protective Services in New York State -- Implementation, Initial Outcomes and Impacts of Pilot Project -- Report to the Governor and Legislature. New York: Office of Children and Family Services. 2011. pp. 1–140. Search this book on
  21. "CANS-PA Project".
  22. "Health Homes Serving Children".
  23. "Data Assessment Registry Mental Health & Addiction".
  24. "Child and Adolescent Needs & Strengths (CANS) and rate setting F.A.Q" (PDF).
  25. "San Francisco Department of Public Health".
  26. "Children's System of Care".
  27. "CANS".
  28. "PerformCare" (PDF).
  29. Liu, Denise; Tan, Michelle Yan Ling; Lim, Amber Yann-Yu; Chu, Chi Meng; Tan, Li Jen; Quah, Saw Han (September 2014). "Profiles of needs of children in out-of-home care in Singapore: School performance, behavioral and emotional needs as well as risk behaviors". Children and Youth Services Review. 44: 225–232. doi:10.1016/j.childyouth.2014.06.019.

Bibliography[edit]

  • Accomazzo, Sarah; Israel, Nathaniel; Romney, Stephanie (17 February 2015). "Resources, Exposure to Trauma, and the Behavioral Health of Youth Receiving Public System Services". Journal of Child and Family Studies. 24 (11): 3180–3191. doi:10.1007/s10826-015-0121-y.
  • Cohen, Janice; Mack, David; Lyons, John; Benchimol, Eric (December 2011). "The pediatric intermed: A new clinical -decision making tool for proactive evaluation of psychosocial stress in children with IBD". Inflammatory Bowel Diseases. 17: S60. doi:10.1097/00054725-201112002-00192.
  • Cordall, K; Snowden, L; Housier, L (2016). "Patterns and priorities of service need identified through the Child and Adolescent Needs and Strengths (CANS) assessment". Child and Youth Services Review (60): 129–135.
  • Dunleavy, Alison M.; Leon, Scott C. (1 November 2011). "Predictors for resolution of antisocial behavior among foster care youth receiving community-based services". Children and Youth Services Review. 33 (11): 2347–2354. doi:10.1016/j.childyouth.2011.08.005.
  • Effland, Vicki Sprague; Walton, Betty A.; McIntyre, Janet S. (1 November 2011). "Connecting the Dots: Stages of Implementation, Wraparound Fidelity and Youth Outcomes". Journal of Child and Family Studies. 20 (6): 736–746. CiteSeerX 10.1.1.366.1829. doi:10.1007/s10826-011-9541-5.
  • Epstein, Richard A.; Schlueter, David; Gracey, Kathy A.; Chandrasekhar, Rameela; Cull, Michael J. (4 November 2015). "Examining Placement Disruption in Child Welfare". Residential Treatment for Children & Youth. 32 (3): 224–232. doi:10.1080/0886571X.2015.1102484.
  • Greenham, Stephanie; Bisnaire, Lise (4 September 2008). "An Outcome Evaluation of an Inpatient Crisis Stabilization and Assessment Program for Youth". Residential Treatment for Children & Youth. 25 (2): 123–143. doi:10.1080/08865710802310012.
  • Griffin, Gene; Martinovich, Zoran; Gawron, Tim; Lyons, John S. (5 June 2009). "Strengths Moderate the Impact of Trauma on Risk Behaviors in Child Welfare". Residential Treatment for Children & Youth. 26 (2): 105–118. doi:10.1080/08865710902872994.
  • Kisiel, C; Fehrenbach, T; Small, L; Lyons, JS (2009). "Assessment of Complex Trauma Exposure, Responses and Service Needs among Children and Adolescents in Child Welfare". . Journal of Child and Adolescent Trauma (2): 143–160.
  • Lyons, JS; Helgerson, J; Fawley, K (2004). "Future directions in the use of psychological assessment for treatment planning and outcomes assessment: predictions and recommendations". The Use of Psychological Testing for Treatment Planning and Outcome Assessment. 1 (3): 367–377.
  • Lyons, JS (2006). "The complexity of communication in an environment with multiple disciplines and professionals: communimetrics and decision support". Medical Clinics of North America (90): 693–701.
  • McGill, K.; Rea, K. (3 September 2015). "New Jersey's Historical Development of a Statewide Children's System of Care, Including the Lessons Learned From Embedding CANS Tools: Developments, Innovations, and Data Analysis". SAGE Open. 5 (3): 215824401560280. doi:10.1177/2158244015602806.
  • McGill, Kenneth; McGill, Scott A. (August 2011). "New Jersey Children's Behavioral Healthcare System: Cross service delivery planning for transitional population of youth (ages 16 and 18+ years)". Evaluation and Program Planning. 34 (3): 316–321. doi:10.1016/j.evalprogplan.2010.11.008. PMID 21194751.
  • Nunally, Jum C (1967). Psychometric Theory. New York: McGraw-Hill. Search this book on
  • Weiner, Dana A.; Leon, Scott C.; Stiehl, Michael J. (23 February 2011). "Demographic, Clinical, and Geographic Predictors of Placement Disruption among Foster Care Youth Receiving Wraparound Services". Journal of Child and Family Studies. 20 (6): 758–770. CiteSeerX 10.1.1.366.2803. doi:10.1007/s10826-011-9469-9.

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