Communimetrics: A Communication Theory of Measurement in Human Service Settings

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Springer Science & Business Media, Jun 19, 2009 - Psychology - 224 pages
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To manage human services based on information, it is necessary to create reliable and valid information through measurement. The traditional approach to measurement in these settings has been psychometric theories (e.g., Nunally, 1978; Lord 1954; 1966); however, psychometric theories have been used to develop measures for purposes of research, not for service delivery. As a result, the focus of these theories of measurement has been on precision and internal consistency reliability. This focus results in measures that are often not helpful to the goals of measurement in service delivery.

In 1956, Virginia Apgar created the first clinimetric measure as an assessment of functioning for new born children (Apgar, 1966). This measurement strategy, which focuses on the clinical utility of information, represents the first significant departure from psychometric theories in measurement in human service delivery. Clinimetrics has informed the development of a variety of simple measures that have proved useful in fast-paced medical environments.

The primary reason for implementing measurement in human services is to communicate. Communication between the consumer and the provider; between the direct service provider and his/her supervisor; within a program, across programs, and across an entire system of services all must be supported by information. Effective management requires strong communication about the shared goals and objectives of the system (i.e., effectively helping people). Taking this logic and building on the concept of simplicity and clinical utility in clinimetrics, a communimetric theory of measurement is advanced that creates measures to optimize their communication value within service delivery applications (Lyons, 2004). Primary characteristics of a communimetric measure include that they are reliable and valid at an item level and immediately translatable into action with regard to service planning. The selection of items is guided by consideration of the information needed to make key decisions in the service delivery process. The measures then become tools—directly supporting the work. Implications for measurement design are considerable. The nature of reliability and validity create alternative considerations for this theory.

During the past decade, communimetric measures have been developed for child-serving systems (e.g., child welfare, mental health, juvenile justice, schools), medical/surgical services, adult mental health services, and entrepreneurial development. More than 30,000 individuals have been trained in the reliable use of one of these tools, and these measures have been used to support the transformation of services in numerous large jurisdictions. Applications have been successfully implemented in Europe, the United States, Canada, and Asia.

At the end of October 2007, in Boston, the 4th annual CANS Conference was dedicated to the use of one of these approaches. There were 270 attendees from 20 states and two Provinces. Registration was closed a week before the conference due to the high level of registration.


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About the author (2009)

John S. Lyons, Ph.D., is a Professor of Psychiatry & Medicine at the Feinberg School of Medicine of Northwestern University where he has served on the faculty for more than two decades. Dr. Lyons has published more than 200 peer-reviewed articles and five books including, "The Measurement and Management of Clinical Outcomes in Mental Health", "Redressing the Emperor: Improving our children’s public mental health system", and "Strategies in Behavioral Healthcare: Total Clinical Outcomes Management". He has developed the communimetric theory of measurement and worked to design and implement this measurement strategy in human services applications in the United States, Canada, Europe, Asian, and Africa.

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