Assertive community treatment across the Atlantic: comparison of model fidelity in the UK and USA
Year: 2003
Type: article
Study design: Observational Study
Abstract: BACKGROUND: The significant reductions in hospital admission demonstrated in US assertive community treatment (ACT) studies have not been replicated in the UK. Explanations cite poor UK 'model fidelity' and/or better UK standard care. No international model-fidelity comparisons exist. AIMS: To compare high-fidelity US ACT teams with a UK team. METHOD: The UK 700's ACT team (n=97) was compared with high-fidelity US ACT teams (n=73) by using two measures: a forerunner of the Dartmouth Assertive Community Treatment schedule (to assess adherence to ACT principles) and 2-year prospective activity data. RESULTS: The UK and US teams had similar high-fidelity scores. Although significant differences were found in the amount and type of activity, practice differences in areas central to ACT were not great. CONCLUSIONS: The failure of UK ACT studies to demonstrate the outcome differences of early US studies cannot be attributed entirely to the lack of ACT fidelity.
Authors: Matthew Fiander, Tom Burns, Gregory J. Mchugo, Robert E. Drake
Institution: St George's, University of London
Language: English
Subfield: Clinical Psychology
Field: Psychology
Domain: Social Sciences
Open Access status: bronze
OpenAlex ID: W2133008505