Evaluation of two implementation strategies in 51 child county public service systems in two states: results of a cluster randomized head-to-head implementation trial.
Evaluation of two implementation strategies in 51 child county public service systems in two states: results of a cluster randomized head-to-head implementation trial.
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DOI：
10.1186/s13012-014-0134-8
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发表时间：
2014-10-14
期刊：
影响因子：
--
通讯作者：
Cruden G
中科院分区：
文献类型：
--
作者：
Brown CH;Chamberlain P;Saldana L;Padgett C;Wang W;Cruden G
关于哪些执行战略对试图采用循证做法的社区最为有益，还有很多东西有待了解。本文介绍了在加州和俄亥俄州的儿童公共服务系统中进行的多维治疗寄养（MTFC）的随机实施试验的结果，包括儿童福利，青少年司法和心理健康。51个县被随机分配到两个不同的实施战略（社区发展小组（CDT）或独立县实施战略（IND））在四个队列的县特征匹配后。我们使用实施完成阶段（SIC）（实施科学6（1）：1-8，2011）比较了这两种策略的实施过程，质量和里程碑成就。每个县的综合得分，结合达到的最后实施阶段，服务的家庭数量和实施质量，被用作主要结果。CDT和IND之间的复合指标无显著差异。其他分析表明，没有证据表明CDT增加了启动项目的县的比例（即，至少有一个家庭在MTFC）。对于那些没有实施MTFC的县，那些在CDT条件下服务的青年人数是研究期间IND的两倍。在成功实现计划启动的县中，那些在CDT条件下完成实施过程更彻底，由SIC测量。我们发现，在第一次安置所需的时间，实现能力，或完成的阶段数的实施条件没有显着差异。这项试验没有导致更高的实施率或更快的实施，但确实提供了证据，证明一旦第一个家庭接受MTFC服务，与IND实施相比，CDT条件下的实施更加稳健。从设计角度来看，这项试验是成功的，因为没有县退出，尽管这项研究是在经济衰退期间进行的。我们认为，这种方法论的测量方法，利用SIC，这是由三个方面的质量，数量和时间，是适合于广泛的实施和转化研究。试验ID：NCT 00880126（ClinicalTrials.gov）。本文的在线版本（doi：10.1186/s13012-014-0134-8）包含补充材料，可供授权用户使用。
Much is to be learned about what implementation strategies are the most beneficial to communities attempting to adopt evidence-based practices. This paper presents outcomes from a randomized implementation trial of Multidimensional Treatment Foster Care (MTFC) in child public service systems in California and Ohio, including child welfare, juvenile justice, and mental health. Fifty-one counties were assigned randomly to one of two different implementation strategies (Community Development Teams (CDT) or independent county implementation strategy (IND)) across four cohorts after being matched on county characteristics. We compared these two strategies on implementation process, quality, and milestone achievements using the Stages of Implementation Completion (SIC) (Implement Sci 6(1):1–8, 2011). A composite score for each county, combining the final implementation stage attained, the number of families served, and quality of implementation, was used as the primary outcome. No significant difference between CDT and IND was found for the composite measure. Additional analyses showed that there was no evidence that CDT increased the proportion of counties that started-up programs (i.e., placed at least one family in MTFC). For counties that did implement MTFC, those in the CDT condition served over twice as many youth during the study period as did IND. Of the counties that successfully achieved program start-up, those in the CDT condition completed the implementation process more thoroughly, as measured by the SIC. We found no significant differences by implementation condition on the time it took for first placement, achieving competency, or number of stages completed. This trial did not lead to higher rates of implementation or faster implementation but did provide evidence for more robust implementation in the CDT condition compared to IND implementation once the first family received MTFC services. This trial was successful from a design perspective in that no counties dropped out, even though this study took place during an economic recession. We believe that this methodologic approach of measurement utilizing the SIC, which is comprised of the three dimensions of quality, quantity, and timing, is appropriate for a wide range of implementation and translational studies. Trial ID: NCT00880126 (ClinicalTrials.gov). The online version of this article (doi:10.1186/s13012-014-0134-8) contains supplementary material, which is available to authorized users.
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影响因子：
3.5
作者：
Elliott, DS;Mihalic, S
通讯作者：
Mihalic, S
DOI：
10.1007/s10488-008-0167-x
发表时间：
2008-07-01
影响因子：
2.6
作者：
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通讯作者：
Bouwman, Gerard
影响因子：
1.8
作者：
Collins, Charles;Harshbarger, Camilla;Hamdallah, Myriam
通讯作者：
Hamdallah, Myriam
影响因子：
3.1
作者：
Chinman, M;Hannah, G;Sheldon, J
通讯作者：
Sheldon, J
影响因子：
3.8
作者：
Glasgow, RE;Davidson, KW;Spring, B
通讯作者：
Spring, B