Supporting Sustainable Positive Interactions in the Child Welfare System: The R3 Supervisor Strategy

支持儿童福利系统中可持续的积极互动：R3 监管策略

• 批准号: 9056288
• 负责人: Lisa Saldana
• 金额: $ 54.79万
• 依托单位: OREGON SOCIAL LEARNING CENTER, INC.
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-09-15 至 2020-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9056288
• 关键词: Accounting; Achievement; Address; Administrator; Adopted; Adoption; Affect; Alcohol or Other Drugs use; Area; Award; Behavior; Behavioral; Characteristics; Child; Child Welfare; Client; Climate; Code; Consultations; Decision Making; Development; Drug usage; Effectiveness; Evaluation; Evidence based intervention; Evidence based practice; Family; Feedback; Funding; Goals; Group Meetings; HIV risk; Homelessness; Hybrids; Imprisonment; Intervention Trial; Job Satisfaction; Knowledge; Leadership; Maps; Measurable; Measures; Mediating; Methods; Monitor; National Institute of Drug Abuse; New York City; Organizational Change; Outcome; Personal Satisfaction; Population; Positioning Attribute; Preventive Intervention; Psychological reinforcement; Public Health; Qualitative Research; Readiness; Recruitment Activity; Risk; Risk Behaviors; Risk-Taking; Role; Safety; Services; Supervision; System; Tennessee; Testing; Time; TimeLine; Training; United States; United States National Institutes of Health; Variant; Video Recording; Vulnerable Populations; Waiting Lists; Writing; collaborative environment; design; early onset substance use; effectiveness trial; evidence base; expectation; high risk; high risk sexual behavior; implementation science; improved; innovation; meetings; mortality; organizational climate; public health relevance; quality assurance; response; scale up; skills; social cognitive theory; treatment as usual; treatment planning; waiver

 DESCRIPTION (provided by applicant): Large knowledge gaps remain regarding strategies to promote change in public child welfare systems (CWS), yet opportunities to evaluate strategies to create system-wide change and the resulting public health impact are rare. The CWS in the United States is populated with vulnerable children and families at high risk for negative outcomes, including substance use, risky sexual behavior, delinquency, incarceration, homelessness, and early mortality. This proposal maps onto PAR 13-055 by addressing the NIH priority to understand methods for "scale-up and sustainability of evidence-based interventions." Leveraging a real-world, federally funded, system-initiated effort to infuse the use of evidence-based principles throughout the multi-levels of the Tennessee CWS workforce, this study will evaluate the effectiveness of a supervisor-targeted implementation strategy in creating organizational change and subsequent positive family outcomes. The R3 Supervisor Strategy was developed to modify the way that the CWS workface supports families toward completing their treatment plans, by utilizing evidence-based behavioral principles found in previous NIDA-funded intervention trials to improve system-level outcomes, including child permanency, stability, and well-being. The R3 strategy provides training, consultation, and fidelity-monitoring to supervisors, who are centrally positioned in the system between caseworkers (who have daily interactions with CWS-involved families) and leadership (who make decisions that affect the organization in which families receive services). The three Rs include reinforcement of (1) effort, (2) relationships and roles, and (3) small steps toward goal achievement. R3 is founded on social learning theory; these reinforcement targets are encouraged in interactions between supervisors and their supervisee- caseworkers and between caseworkers and the families they serve. Utilizing a variation of a dynamic wait-listed design, four Tennessee CWS regions (serving over 12,000 children annually) that have been awarded a federal Title-IV-E Waiver and have opted to adopt R3 as part of their waiver plan will be observed. The CWS workforce (n = 85 regional administrators, 50 supervisors, and 220 caseworkers) will be recruited to participate in a Hybrid Type II trial of the effectiveness of R3 in achieving organizational and subsequent positive system-level, client-level outcomes. This project will examine the potential of R3 to influence supervisor interactions with caseworkers and subsequent family outcomes (Aim 1); the impact of R3 on organizational characteristics known to impact staff retention and the successful adoption of innovations such as climate, leadership, readiness, and citizenship (Aim 2); and the potential for maintaining fidelity standards to the R3 strategy as consultation and coaching are fully transferred to the system (Aim3). This project will inform the potential for R3 to effectively infuse evidence-based principles into the daily interactions of those involved in th CWS, and to narrow the gap for achieving outcomes for one of the nation's most costly and vulnerable populations-families involved in the child welfare system.

 描述（由申请人提供）：关于促进公共儿童福利系统（CWS）变革的策略仍然存在巨大的知识差距，但评估创造全系统变革的策略以及由此产生的公共卫生影响的机会很少。美国的 CWS 居住着易受伤害的儿童和家庭，他们面临着高风险的负面结果，包括药物滥用、危险性行为、犯罪、监禁、无家可归和过早死亡。该提案通过解决 NIH 优先事项来映射 PAR 13-055，以了解“循证干预措施的规模化和可持续性”的方法。本研究将利用现实世界中由联邦政府资助、系统发起的努力，在田纳西州 CWS 的各个层面的员工队伍中注入基于证据的原则，评估以主管为目标的实施策略在创造组织变革和随后的积极家庭成果方面的有效性。 R3 主管策略的制定是为了改变 CWS 工作面支持家庭完成治疗计划的方式，利用之前 NIDA 资助的干预试验中发现的循证行为原则来改善系统层面的结果，包括儿童的永久性、稳定性和福祉。 R3 策略提供培训、咨询和保真度监控 主管在系统中处于中心位置，介于个案工作者（与 CWS 涉及的家庭进行日常互动）和领导层（做出影响家庭接受服务的组织的决策）之间。三个 R 包括强化 (1) 努力， (2) 关系和角色，以及 (3) 实现目标的小步骤。 R3建立在社会学习理论之上；这些强化目标在督导者与其下属的社工之间以及社工与其所服务的家庭之间的互动中受到鼓励。利用动态候补设计的变体，将观察已获得联邦 Title-IV-E 豁免并选择采用 R3 作为其豁免计划一部分的四个田纳西州 CWS 地区（每年为超过 12,000 名儿童提供服务）。 CWS 工作人员（n = 85 名区域管理员、50 名主管和 220 名个案工作者）将被招募参加混合 II 型试验，以验证 R3 在实现组织和后续积极的系统级、客户级成果方面的有效性。该项目将研究 R3 影响主管与个案工作者的互动以及随后的家庭结果的潜力（目标 1）； R3 对已知会影响员工保留和创新成功采用的组织特征的影响，例如氛围、领导力、准备情况和公民意识（目标 2）；随着咨询和辅导完全转移到系统中，保持对 R3 策略的忠诚度标准的潜力（目标 3）。该项目将揭示 R3 的潜力，即有效地将基于证据的原则融入 CWS 参与者的日常互动中，并缩小为全国成本最高和最脆弱的人群之一（参与儿童福利系统的家庭）实现成果的差距。