The role of cross-system collaboration in implementation of evidence-based substance use practices in child welfare

项目总结 这个导师职业奖的总体目标是建立我的独立研究生涯，以 在实施循证实践(EBP)中使用社区参与战略，以便 改善对患有药物使用障碍(SU)的弱势人群，特别是父母的服务 苏参与了儿童福利服务(CWS)。父母SU是最近儿童死亡率上升的主要原因 CWS病例，父母SU与较差的结局相关，如反复虐待儿童； 然而，让家长参与SU服务是具有挑战性的。服务提供需要跨部门协作 多个系统(CWS、治疗机构)和从最初确定治疗需求和 治疗转诊至治疗参与和最终CWS病例结案；因此，有多个要点 在那里，父母可能会失去照顾。该项目提出，CWS中父母的不良结局是由于(1) 在有效跟踪护理流程和确定服务差距方面面临挑战，以及(2) CWS和SU提供商。此外，存在解决服务缺陷的循证做法(EBP)，但 要成功实施，需要跨系统的协作和社区的参与。 该项目旨在通过利用社区来改善CWS为家长提供的SU服务 EBP采用和实施规划中的参与度和数据驱动战略。研究报告 该项目的目标包括为CWS中的父母定义SU护理级联，并计算级联结果 (例如，治疗完成率等)使用行政数据(目标1)；查明促进者和障碍 通过对参与CWS的父母和CWS人员的定性访谈来级联提供服务， SU提供商和社区合作伙伴(AIM 2)；以及使用AIM 1和AIM 2数据来确定级联的区域 为了改进，应选择适当的EBP来满足需求，并制定实施计划(目标3)。 这些目标将由一个社区联盟执行，该联盟将在目标1中建立并参与 在整个项目中。拟议的研究活动包括使用社区参与战略和 建立社区联盟；进行行政、定性和混合方法分析；以及 使用实施映射来制定实施计划。我已经发现了我的培训中的关键差距 并组建了一支强大的导师团队，通过以下培训目标解决这些不足：(1) 发展CWS方面的专业知识，并与CWS一起进行研究(Saldana博士，Wiehe)；(2)精通 使用行政数据(莫纳汉博士)；(3)在使用社区参与战略方面培养专门知识 实施(Wiehe、Aalsma、Saldana博士)；以及(4)获得研究伦理方面的高级培训(Dr. 奥尔斯马)。这些培训目标与提议的项目一致，对于我作为一名 独立研究人员。该项目是朝着开发更大的研究计划迈出的第一步，该研究计划寻求 改善对CWS患者家长和其他SU弱势人群的服务。

PROJECT SUMMARY The overall goal of this mentored career award is to establish my independent research career centered on using community engagement strategies in implementation of evidence-based practices (EBPs) in order to improve service provision for vulnerable populations with substance use disorders (SU), specifically, parents with SU involved in child welfare services (CWS). Parental SU is the primary reason for recent increases in CWS cases, and parental SU is associated with worse outcomes, such as repeated child maltreatment; however, engaging parents in SU services is challenging. Service provision requires collaboration across multiple systems (CWS, treatment agencies) and multiple steps from initial identification of treatment need and treatment referral to treatment engagement and eventual CWS case closure; as such, there are multiple points where parents can fall out of care. The project proposes that poor outcomes for parents in CWS are due to (1) challenges in effectively tracking care processes and identifying service gaps and (2) poor collaboration across CWS and SU providers. Moreover, evidence-based practices (EBPs) that address service deficits exist, but collaboration across systems and involvement from the community is needed for successful implementation. The project seeks to improve SU service provision for parents in CWS through use of community engagement and data-driven strategies in EBP adoption and implementation planning. The Research Aims of the project include defining a SU care cascade for parents in CWS and calculating cascade outcomes (e.g., rates of treatment completion, etc.) using administrative data (Aim 1); identifying facilitators and barriers to cascade service provision through qualitative interviews with parents involved in CWS and CWS personnel, SU providers, and community partners (Aim 2); and using Aim 1 and 2 data to identify an area of the cascade to improve, select an appropriate EBP to address the need, and develop an implementation plan (Aim 3). These aims will be will be carried out by a community alliance which will be established in Aim 1 and engaged throughout the project. Proposed research activities include using community engagement strategies and establishing a community alliance; conducting administrative, qualitative, and mixed methods analyses; and using implementation mapping to develop an implementation plan. I have identified critical gaps in my training and assembled a strong mentorship team to address these deficits through the following Training Goals: (1) develop expertise in CWS and conducting research with CWS (Drs. Saldana, Wiehe); (2) become proficient in use of administrative data (Dr. Monahan); (3) develop expertise in using community engagement strategies in implementation (Drs. Wiehe, Aalsma, Saldana); and (4) gain advanced training in research ethics (Dr. Aalsma). These training goals align with the proposed project and are necessary for my success as an independent researcher. This project is the first step towards developing a larger research program that seeks to improve services for parents involved in CWS and other vulnerable populations with SU.