Interagency Collaborative Teams to Scale-up Evidence Based Practice

描述(申请人提供)：忽视儿童是一个严重的公共卫生问题，占儿童福利转介的%-超过身体或性虐待。儿童忽视与发育迟缓、认知困难、语言发育迟缓、社交和情绪退缩以及在学习新任务时缺乏自信和自信有关。作为成年人，被忽视的儿童面临更大的暴力和犯罪行为及相关问题的风险。因此，忽视儿童是个人发展轨迹不佳和对社会产生负面影响的一个明显的风险因素。循证做法(EBPS)在儿童福利系统中的实施一直非常缓慢。大多数疏忽案件都是在松散的社会支持和案件管理的基础上，通过非循证的家庭保全/家庭团聚(FP/FR)服务提供的。SafeCare(R)是一种专门为改善父母忽视行为而设计的EBP。超过60种出版物支持SafeCare功效或有效性。实施SafeCare还与减少工作人员的倦怠和流失率有关。NIMH资助的两项正在进行的俄克拉何马州SafeCare实施对照试验的研究结果初步发现，一些实施特征是关键的(例如，体内提供者指导)。在这项提案中，我们将测试一种新的、有前景的实施方法，该方法是为将诸如SafeCare这样的EBP传输到现有的社区组织网络而开发的。实施方法使用跨机构协作团队(ICT)来发展EBP的当地专业知识，为培训中的治疗师提供体内指导，并通过在多个机构之间分配专业知识、责任和工作量来应对实施的常见威胁。信息和通信技术方法首先培养了一支素质极高的机构间团队。最初的ICT(种子团队)然后为其他提供商机构的顺序实施提供体内指导和培训。信息和通信技术模式的假设是支持摆脱对干预开发人员的依赖，同时保持对EBP模式的高保真。这项研究利用了加州圣地亚哥县基金会资助的SafeCare实施。拟议的研究将审查信通技术模式是否能够在所有FP/FR服务提供商中培养全系统的SafeCare专业知识，同时保持高水平的模型保真度。我们提出了一项混合方法(定量/定性)的研究，以检查和描述个别提供者员工、系统和组织因素以及ICT方法的过程和结果之间的关系。

DESCRIPTION (provided by applicant): Child neglect is a serious public health concern that accounts for 64% of child-welfare referrals - more than physical or sexual abuse. Child neglect is associated with developmental delays, cognitive difficulties, delayed language development, social and emotional withdrawal, and low confidence and assertiveness in learning new tasks. As adults, neglected children are at increased risk for violence and criminal behavior and related problems. Thus, child neglect is a clear risk factor for poor individual developmental trajectories and for negative societal impact. Implementation of evidence-based practices (EBPs) in child welfare systems has been very slow. Most neglect cases are served with non evidence-based in-home family preservation/family reunification (FP/FR) services, based on loose social support and case management. Safecare(R) is an EBP designed specifically to improve parent neglect behaviors. More than 60 publications support SafeCare efficacy or effectiveness. Implementation of SafeCare is also associated with reduced staff burnout and turnover. Results from two ongoing NIMH-funded studies of a statewide controlled-trial of SafeCare implementation in Oklahoma have yielded initial findings that some implementation features are critical (e.g., in vivo provider coaching). In this proposal, we will test a new and promising implementation approach developed for transporting EBPs like SafeCare into existing networks of community-based organizations. The implementation approach uses Interagency Collaborative Teams (ICTs) to develop local expertise in an EBP, to provide in-vivo coaching to therapists in training, and to counter common threats to implementation by distributing expertise, responsibility, and workload across multiple agencies. The ICT approach first develops an interagency team of exceptionally high quality. The initial ICT (seed team) then provides in-vivo coaching and training for sequential implementations at additional provider agencies. The ICT model is hypothesized to support transition away from reliance on intervention developers, while sustaining high levels of fidelity to the EBP model. This study takes advantage of a foundation-funded implementation of SafeCare in San Diego County, California. The proposed research will examine whether or not the ICT model can develop system- wide SafeCare expertise across all FP/FR service providers while maintaining high levels of model fidelity. We propose a mixed-methods (quantitative/qualitative) study to examine and describe the relationships between individual provider staff, system, and organizational factors, and processes and outcomes of the ICT approach.