Information Letter / Consent Form
McEwan Housing –
Annual Evaluation of Supportive Housing Services and Client Outcomes
Introduction & Eligibility
As a current client of the supportive housing program at McEwan Housing, you are invited to take part in our annual evaluation of supportive housing services and client outcomes. This evaluation will be in the form of an interview, offered to you by your worker as a part of the standard intake process. This interview process is one part of our agency’s ongoing practice of evaluating the effectiveness of our services. We want to show the outcomes of our work, improve the services we provide, and ensure we provide services that can be of most benefit to you.
Should you have any questions, please contact:
Kay Roesslein, Director
Telephone: 416-929-6228 x223
Email:
Background and Purpose
The purpose of asking these questions is to measure the outcomes and effectiveness of the services we provide. We are interested in the impact of providing supportive housing services on the quality of life for people living with HIV (PHAs). We will use this information to improve care planning for our clients, provide services that are of the most benefit to our clients and to show changes that happen over time in people’s health. This data will also help us show the effectiveness of our programs to our clients, funders, board of directors, and others in the community.
Your Involvement
As part of routine service, once a year you will be asked a series of confidential questions during discussions with your worker where we will ask you about: your housing history, health, access to services, interaction with the criminal justice system, emotional well-being, and some other personal information (e.g., OHIP number, gender, date of birth). Some of your answers may lead to a conversation between you and your housing/support worker about whether you could benefit from being referred to additional health or support services. We will ask for your permission to use your health card number, gender, and date of birth to link and retrieve the information from the provincial administrative health service database (e.g., emergency room visits, hospital stays, doctor’s visits, etc.).
Compensation
We are using this information to evaluate our services and for program planning as part of our ongoing service delivery process, and as such there is no monetary compensation for your time.
Potential Benefits
The time with your worker can be used to discuss your needs, goals, and care plans. There may also be an indirect benefit with providing data that can support ongoing improvement and planning to the programs and services offered at McEwan Housing.
Potential Risks and/or Discomforts
Some of the questions asked are of a personal nature and may make you feel uncomfortable. You are not required to answer any question and you can stop the questions at any time. Stopping or skipping questions will not change the services you now receive or will receive in the future from McEwan Housing. Your answers will not affect your housing situation. Your worker is available to provide support if you would like to speak about how you are feeling.
Participation and/or Withdrawal
You can choose to participate in this evaluation or not. You can withdraw from or stop the survey for any reason. You can refuse to answer (i.e., skip) any question you wish. Withdrawal, skipping questions, or stopping the interview will not affect the services you receive now or in the future from McEwan Housing. Your answers will not affect your housing situation. If you withdraw from the survey, your data will be destroyed.
Confidentiality
Any information asked for the purpose of this project will remain confidential. No personal names will be used in any reports, presentations, or publications. All data will be stored securely in Canada and identified with a unique ID. All information will be destroyed five years after the evaluation is completed and data is analyzed [evaluation is from 2013 – 2018; data destroyed in 2023]. The interview will meet the legal requirements of Personal Health Information Protection Act (Ontario) and Personal Information Protection and Electronic Documents Act (Canada).
Feedback of the Results
A summary document of key evaluation findings will be made available at McEwan Housing within the evaluation period. The findings may be presented to agency staff, the Executive Director, and the Board of Directors. However, your identity will not be revealed and no personal names will be used.
Subsequent Use of Data
This information is being collected for evaluation, program planning, and to inform future services at the agency. This information may also be used in future agency reports, presentations, and funding applications. Your data will be analyzed together with the data from our partner agencies involved in this evaluation project.[1] This will help us see the combined effect of our supportive housing services and how our services compare with others across the province.
You do not have to provide your health card number in order to participate in the evaluation. However, we ask that you share your OHIP card number with us so that your information from the interview can be linked with other administrative/medical data (e.g., emergency room visits, etc.). Every time you access a medical service, it is recorded in a separate provincial database and referred to as ‘administrative data’. Linking your interview data with additional health-related ‘administrative data’ allows us and the evaluation project researchers to connect your use of our supportive housing services and your use of these other medical services.
There are very strict privacy measures in place when information from more than one source is linked together about the same person. Your data is de-identified before it is provided to researchers. This means once the data is linked together we remove your identifiers (no personal name) before it is provided to the researchers. The researchers will keep the data confidential. Under no circumstances will personal names be released to researchers.
RIGHTS OF PARTICIPANTS
You can choose to participate in this evaluation or not. You are free to withdraw from the interview for any reason. Withdrawal, skipping questions, choosing to not answer any question, or stopping the interview will not affect the services you receive now or in the future from McEwan Housing. Your answers will not affect your housing situation. If you withdraw from the survey, your data will be destroyed.
If you have any questions about this evaluation, please contact:
Kay Roesslein, Director
Telephone: 416-929-6228 x223
Email:
Consent Form
McEwan Housing
– Annual Evaluation of Supportive Housing Services and Outcomes
I have read and understand the information in the letter above.
Any questions I had have been answered and I understand what is involved in the evaluation.
I realize that my participation in this evaluation is voluntary.
I may withdraw, choose not to answer (skip) any question, or stop the interview at any time.
I also realize participating, withdrawing, skipping questions, or stopping the interview will not affect the services I receive now or may in future from McEwan Housing.
In order to participate in the evaluation project, I consent to the following:
· To voluntarily participate in the evaluation
· To participate in the face-to-face confidential interview
· To allow my worker to review these interview results and discuss with me for my care planning
· To allow the agency to release my interview data (de-identified) to be analyzed together with data from the other partner agencies for this evaluation project.
· To allow the presentation of the findings from the evaluation in future reports, presentations, publications, and funding applications. These documents will not contain personal names and I will not be identified any way.
I consent to have my interview data linked to additional health-related administrative data via my health card number. ð Yes ð No
I have received a copy of this information letter and consent form to take home with me.
ð Yes ð No
______
Name of Participant (print) Name of Housing Agency Representative (print)
______
Participant Signature Housing Agency Representative Signature
______
Date Date
To the best of my ability I have fully explained to the participants the nature and purpose of this interview and overall evaluation. I have provided answers to questions that he or she may have. I believe that this individual fully understands the implications and voluntary nature of the evaluation.
[1] Fife House and McEwan Housing&Support Services (Toronto), John Gordon Home (London), Bruce House (Ottawa), Abercrombie Place / ARCH-HIV Resources & Community Health (Guelph), and Positive Living Niagara (St. Catherines)