Interagency Collaborative Teams to Scale-up Evidence Based Practice

描述（由申请人提供）：儿童忽视是一个严重的公共卫生问题，占儿童福利转介的64%——超过身体虐待或性虐待。儿童忽视与发育迟缓、认知困难、语言发展迟缓、社交和情感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，被忽视的儿童面临暴力和犯罪行为以及相关问题的风险增加。因此，儿童被忽视是导致个人发展轨迹不佳和产生负面社会影响的一个明显风险因素。在儿童福利系统中，循证实践（ebp）的实施一直非常缓慢。大多数忽视案件都是通过基于松散的社会支持和案件管理的非循证家庭家庭保存/家庭团聚（FP/FR）服务提供的。Safecare(R)是专门为改善父母忽视行为而设计的EBP。超过60份出版物支持SafeCare的有效性。安全关怀的实施也与减少员工倦怠和流动率有关。nimh资助的两项正在进行的在俄克拉何马州实施SafeCare的全州对照试验的研究结果初步发现，一些实施特征是至关重要的（例如，在体内的提供者指导）。在本提案中，我们将测试一种新的、有前途的实施方法，该方法是为将像SafeCare这样的ebp传输到现有的社区组织网络而开发的。实施方法使用机构间协作团队（ICTs）来开发EBP的本地专业知识，为正在培训的治疗师提供现场指导，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过程中的常见威胁。信息和通信技术方法首先培养了一支高质量的机构间团队。最初的ICT（种子团队）然后为其他供应商机构的后续实施提供体内指导和培训。假设ICT模型支持从依赖干预开发人员的过渡，同时保持对EBP模型的高保真度。本研究利用了加州圣地亚哥县基金会资助的安全护理实施项目。拟议的研究将检查ICT模型是否可以在所有FP/FR服务提供商中开发系统范围的安全护理专业知识，同时保持高水平的模型保真度。我们提出了一种混合方法（定量/定性）研究，以检查和描述个体供应商员工、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.