An innovative medical and dental hygiene clinic for street youth: Results of a process evaluation

• A focus on program fidelity, dose, reach, and satisfaction was informative.
• A mixed methods design strengthened the trustworthiness of results.
• The “hybrid model” of evaluation led to timely program improvements.
• Evaluation and implementation science can build on each other's knowledge base.

Canada has a noteworthy reputation for high quality health care. Nonetheless, street youth are one of our most vulnerable yet underserved populations. Consequently, a medical and dental clinic was created in downtown Ottawa, Ontario to respond to their needs. The purpose of this study is to describe a process evaluation of the clinic during its first year of operation with a focus on program fidelity, dose, reach, and satisfaction. A mixed methods approach was used involving interviews with providers, focus groups with street youth, analysis of Electronic Medical Record (EMR) data, and supplemental information such as document reviews. The evaluation identified areas that were working well along with challenges to program implementation. Areas of concerns and possible solutions were presented to the management team that then helped to plan and make improvements to the clinic. Our evaluation design and working relationship with clinic management promoted the integration of real-time evidence into program improvements.