Interagency Collaborative Teams to Scale-up Evidence Based Practice

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、社交和情感退缩以及学习新任务的信心和自信心低下有关。作为成年人，被忽视的儿童遭受暴力和犯罪行为及相关问题的风险增加。因此，忽视儿童是造成个人发展轨迹不良和负面社会影响的一个明显风险因素。在儿童福利系统中实施循证做法的速度非常缓慢。大多数被忽视的案件都是在松散的社会支持和案件管理的基础上，提供非循证的家庭保护/家庭团聚服务。Safecare（R）是一种EBP，专门用于改善父母忽视行为。超过60篇出版物支持SafeCare的功效或有效性。实施SafeCare也与减少工作人员的倦怠和流动有关。两项由NIMH资助的正在进行的研究结果表明，在俄克拉荷马州进行的全州范围内的安全护理实施对照试验已经产生了初步结果，即一些实施特征是至关重要的（例如，体内提供者指导）。在这项提案中，我们将测试一种新的和有前途的实施方法，用于将SafeCare等EBP传输到现有的社区组织网络中。实施方法使用机构间协作小组（ICT），以开发EBP的本地专业知识，提供培训中的治疗师在体内辅导，并通过在多个机构分配专业知识，责任和工作量来应对实施的共同威胁。信息和通信技术方法首先建立一个高质量的机构间小组。最初的信息和通信技术（种子小组）随后为在其他提供机构的后续实施提供现场辅导和培训。信息和通信技术模型的假设，以支持过渡远离依赖干预开发，同时保持高水平的保真度的EBP模型。这项研究利用了基金会资助的SafeCare在加州圣地亚哥县的实施。拟议的研究将检查信息和通信技术模型是否可以在所有FP/FR服务提供商中开发系统范围的SafeCare专业知识，同时保持高水平的模型保真度。我们提出了一个混合方法（定量/定性）的研究，检查和描述个别供应商的工作人员，系统和组织因素，以及过程和结果的ICT方法之间的关系。 公共卫生相关性：儿童忽视是一个严重的公共卫生问题，导致儿童发育不良和成人结局。本研究将测试一种创新模式，以实施基于证据的儿童忽视干预。将建立机构间合作小组，提供分布在各机构的当地专业知识，以培训和指导服务提供者达到高水平的循证实践保真度，同时减少对干预开发人员的依赖。

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. PUBLIC HEALTH RELEVANCE: Child neglect is a serious public health concern responsible for poor child development and adult outcomes. This study will test an innovative model to implement an evidence-based child-neglect intervention. Interagency Collaborative Teams will be developed to provide local expertise distributed across agencies to train and coach service providers to high levels of evidence-based practice fidelity while reducing reliance on intervention developers.