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Kerns SEU, Maddox SJ, Berhanu RE, Allan H, Wilson RA, Chiesa A, Orsi-Hunt R, McCarthy LP, Henry LJ, Smith CO. An Equity-Focused Assessment of Evidence-Based Parenting Intervention Research. Clin Child Fam Psychol Rev 2024; 27:279-299. [PMID: 38753099 PMCID: PMC11222220 DOI: 10.1007/s10567-024-00479-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/09/2024] [Indexed: 07/04/2024]
Abstract
Evidence-based parenting interventions (EBPI) support children and families to promote resilience, address emotional and behavioral concerns, and prevent or address issues related to child maltreatment. Critiques of EBPIs include concerns about their relevance and effectiveness for diverse populations when they are implemented at population scale. Research methods that center racial equity and include community-based participatory approaches have the potential to address some of these concerns. The purpose of the present review was to document the extent to which methods associated with promoting racial equity in research have been used in studies that contribute to the evidence base for programs that meet evidentiary standards for a clearinghouse that was developed to support the Family First Prevention Services Act in the United States. We developed a coding system largely based on the Culturally Responsive Evaluation model. A sample of 47 papers that are part of the evidence base for ten in-home parent skill-based programs were reviewed and coded. Only three of 28 possible codes were observed to occur in over half of the studies (including race/ethnicity demographic characteristics, conducting measure reliability for the study sample, and including information on socioeconomic status). Although the overall presence of equity-informed methods was low, a positive trend was observed over time. This review highlights ways in which rigorous research can incorporate racial equity into the planning, design, execution, and interpretation and dissemination of programs of study. We posit that doing so improves the external validity of studies while maintaining high-quality research that can contribute to an evidence base.
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Affiliation(s)
- Suzanne E U Kerns
- The Kempe Center for the Prevention and Treatment of Child Abuse and Neglect, Department of Pediatrics, School of Medicine, University of Colorado Anschutz, Aurora, USA.
| | - Samuel J Maddox
- Department of Psychology, Clayton State University, Morrow, USA
| | - Ruth E Berhanu
- The Kempe Center for the Prevention and Treatment of Child Abuse and Neglect, Department of Pediatrics, School of Medicine, University of Colorado Anschutz, Aurora, USA
| | - Heather Allan
- The Kempe Center for the Prevention and Treatment of Child Abuse and Neglect, Department of Pediatrics, School of Medicine, University of Colorado Anschutz, Aurora, USA
| | - Rachel A Wilson
- The Kempe Center for the Prevention and Treatment of Child Abuse and Neglect, Department of Pediatrics, School of Medicine, University of Colorado Anschutz, Aurora, USA
| | - Antonia Chiesa
- The Kempe Center for the Prevention and Treatment of Child Abuse and Neglect, Department of Pediatrics, School of Medicine, University of Colorado Anschutz, Aurora, USA
| | - Rebecca Orsi-Hunt
- The Kempe Center for the Prevention and Treatment of Child Abuse and Neglect, Department of Pediatrics, School of Medicine, University of Colorado Anschutz, Aurora, USA
| | - Lauren Pryce McCarthy
- The Kempe Center for the Prevention and Treatment of Child Abuse and Neglect, Department of Pediatrics, School of Medicine, University of Colorado Anschutz, Aurora, USA
| | - Lesly J Henry
- Department of Psychology, Clayton State University, Morrow, USA
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Piper KN, Jahn A, Escoffery C, Woods-Jaeger B, Nunn A, Schwartz DP, Smith-Curry C, Sales J. A mixed methods evaluation of family-driven care implementation in juvenile justice agencies in Georgia. HEALTH & JUSTICE 2024; 12:8. [PMID: 38407654 PMCID: PMC10895769 DOI: 10.1186/s40352-024-00261-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 02/07/2024] [Indexed: 02/27/2024]
Abstract
BACKGROUND Improving family engagement in juvenile justice (JJ) system behavioral health services is a high priority for JJ systems, reform organizations, and family advocacy groups across the United States. Family-driven care (FDC) is a family engagement framework used by youth-serving systems to elevate family voice and decision-making power at all levels of the organization. Key domains of a family-driven system of care include: 1) identifying and involving families in all processes, 2) informing families with accurate, understandable, and transparent information, 3) collaborating with families to make decisions and plan treatments, 4) responding to family diversity and inclusion, 5) partnering with families to make organizational decisions and policy changes, 6) providing opportunities for family peer support, 7) providing logistical support to help families overcome barriers to participation, and 8) addressing family health and functioning. FDC enhances family participation, empowerment, and decision-making power in youth services; ultimately, improving youth and family behavioral health outcomes, enhancing family-child connectedness, and reducing youth recidivism in the JJ setting. METHODS We evaluated staff-perceived adoption of the eight domains of FDC across detention and community services agencies in the state of Georgia. We collected mixed methods data involving surveys and in-depth qualitative interviews with JJ system administrators, staff, and practitioners between November 2021- July 2022. In total, 140 individuals from 61 unique JJ agencies participated in surveys; and 16 JJ key informants participated in qualitative interviews. RESULTS FDC domains with the highest perceived adoption across agencies included identifying and involving families, informing families, collaborative decision-making and treatment planning, and family diversity and inclusion. Other domains that had mixed or lower perceived adoption included involving families in organizational feedback and policy making, family peer support, logistical support, and family health and functioning. Adoption of FDC domains differed across staff and organizational characteristics. CONCLUSIONS Findings from this mixed methods assessment will inform strategic planning for the scale-up of FDC strategies across JJ agencies in the state, and serve as a template for assessing strengths and weaknesses in the application of family engagement practices in systems nationally.
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Affiliation(s)
- Kaitlin N Piper
- Department of Behavioral, Social, and Health Education Sciences, Rollins School of Public Health, Emory University, 1518 Clifton Road, Atlanta, GA, USA.
| | - Alexandra Jahn
- Department of Behavioral, Social, and Health Education Sciences, Rollins School of Public Health, Emory University, 1518 Clifton Road, Atlanta, GA, USA
| | - Cam Escoffery
- Department of Behavioral, Social, and Health Education Sciences, Rollins School of Public Health, Emory University, 1518 Clifton Road, Atlanta, GA, USA
| | - Briana Woods-Jaeger
- Department of Behavioral, Social, and Health Education Sciences, Rollins School of Public Health, Emory University, 1518 Clifton Road, Atlanta, GA, USA
| | - Amy Nunn
- Department of Social and Behavioral Sciences, Brown University School of Public Health, Providence, RI, USA
| | | | | | - Jessica Sales
- Department of Behavioral, Social, and Health Education Sciences, Rollins School of Public Health, Emory University, 1518 Clifton Road, Atlanta, GA, USA
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[Interventions for Children and Adolescents Living in Foster or Institutional Care - A Systematic Review]. Prax Kinderpsychol Kinderpsychiatr 2022; 71:23-38. [PMID: 35023823 DOI: 10.13109/prkk.2022.71.1.23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Children or adolescents living in foster or institutional care received so far insufficient consideration in therapy intervention research. At the same time, they are a high-risk group for developing mental illness. The aim of this systematic review is to record evidence-based psychotherapeutic interventions of the past 15 years on a national and international level that address children and young people living in foster care and youth welfare institutions and their mental health. Through a systematic literature research, interventions for the target group described were identified and analyzed about their specificity and evidence. From 170 publications, ten interventions with sufficient evidence could be included in the present analysis. The result of the current literature research shows that further specialized psychiatric-psychotherapeutic interventions for children in foster care and youth welfare institutions are necessary. Regarding the transferability to the German youth welfare and health system, cross-system and interdisciplinary cooperation is needed. Hereafter further research is required to establish specific and evidence-based intervention approaches.
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Mersky JP, Topitzes J, Janczewski CE, Lee CTP, McGaughey G, McNeil CB. Translating and Implementing Evidence-Based Mental Health Services in Child Welfare. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2021; 47:693-704. [PMID: 31925601 DOI: 10.1007/s10488-020-01011-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Children in the child welfare system with mental health difficulties seldom receive evidence-based treatment (EBT) despite the abundance of validated interventions that exist. This manuscript describes two projects aimed at increasing access to EBTs. The first is a completed field trial of an adapted parent-child interaction therapy intervention with foster-parent child dyads. New findings are presented from variable- and person-centered analyses of impact on diverse symptom profiles. The second is an ongoing statewide initiative that is increasing access to multiple EBTs while navigating implementation barriers. Lessons learned for bridging gaps between children's mental health research, services, and policy are discussed.
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Affiliation(s)
- Joshua P Mersky
- Helen Bader School of Social Welfare, University of Wisconsin-Milwaukee, 2400 E. Hartford Ave., Milwaukee, WI, 53211, USA.
| | - James Topitzes
- Helen Bader School of Social Welfare, University of Wisconsin-Milwaukee, 2400 E. Hartford Ave., Milwaukee, WI, 53211, USA
| | - Colleen E Janczewski
- Helen Bader School of Social Welfare, University of Wisconsin-Milwaukee, 2400 E. Hartford Ave., Milwaukee, WI, 53211, USA
| | - Chien-Ti Plummer Lee
- Helen Bader School of Social Welfare, University of Wisconsin-Milwaukee, 2400 E. Hartford Ave., Milwaukee, WI, 53211, USA
| | | | - Cheryl B McNeil
- Department of Psychology, West Virginia University, Morgantown, WV, USA
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Winters A, Hooley C, Gopalan G. Absorptive capacity in child welfare: A qualitative study with child welfare staff eliciting key factors for evidence-based practice adoption. JOURNAL OF PUBLIC CHILD WELFARE 2021; 16:704-723. [PMID: 36386436 PMCID: PMC9642977 DOI: 10.1080/15548732.2021.1959489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 07/14/2021] [Accepted: 07/20/2021] [Indexed: 06/16/2023]
Abstract
Child Welfare (CW) provides an array of services to meet the needs of families, requiring agencies to be malleable in their ability to absorb new practices. Absorptive capacity (ACAP) refers to the routines and processes in which an organization acquires, assimilates, and applies new knowledge. ACAP has yet to be the focus of implementation research in CW settings. This exploratory study elicited feedback from CW staff in determining factors to consider when absorbing a new practice. Themes of logistic support, agency culture, and feedback from families emerged. Findings offer insights for CW agencies to consider when adopting a new practice.
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Affiliation(s)
- Andrew Winters
- University of Louisville, Kent School of Social Work, Louisville, KY, 40292
| | - Cole Hooley
- Brigham Young University, School of Social Work, Provo, UT 84602
| | - Geetha Gopalan
- City University of New York, Silberman School of Social Work at Hunter College, New York, NY 10035
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Villodas MT, Moses JO, Cromer KD, Mendez L, Magariño LS, Villodas FM, Bagner DM. Feasibility and promise of community providers implementing home-based parent-child interaction therapy for families investigated for child abuse: A pilot randomized controlled trial. CHILD ABUSE & NEGLECT 2021; 117:105063. [PMID: 33930663 DOI: 10.1016/j.chiabu.2021.105063] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 03/22/2021] [Accepted: 03/31/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Despite evidence supporting Parent-Child Interaction Therapy's (PCIT) effectiveness for maltreatment prevention, its integration in child welfare services (CWS) has been challenging. OBJECTIVE Using a pilot randomized controlled trial design, we evaluated the (1) feasibility of training therapists from CWS providers to implement home-based PCIT (2) feasibility of retaining parent-child dyads at-risk for child abuse in voluntary PCIT services, and (3) promise of PCIT for improving parenting skills. PARTICIPANTS AND SETTING Between 2015-2017, 23 therapists from CWS providers and 55 caregiver-child dyads who were determined to be at moderate-to-high risk for physical and/or emotional abuse, remained in the same home, and were referred for voluntary parenting services following a child protective investigation participated. METHODS We trained 14 therapists in home-based PCIT and randomly assigned participating dyads to receive PCIT or services as usual (SAU). Dyads completed baseline and post-treatment assessments, including self-reported and observed parenting skills. RESULTS All therapists successfully completed the PCIT training; none completed full certification requirements. Of all randomized dyads, 51 % completed at least one treatment session, and the mean number of treatment sessions was 10.83. Caregivers assigned to PCIT used more self-reported (d = .72) and observed (d = .59) positive parenting skills post-treatment than caregivers assigned to SAU. Negative, inconsistent, and punitive parenting strategies and parenting stress did not significantly differ between caregivers assigned to PCIT and SAU. CONCLUSIONS Despite several challenges to feasibly implementing PCIT in community-based child welfare settings, even a small dose of PCIT improved positive parenting skills among at-risk parent-child dyads.
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Affiliation(s)
- Miguel T Villodas
- Department of Psychology, San Diego State University, United States; Department of Psychology, Florida International University, United States; Department of Psychology, University of Utah, United States.
| | - Jacqueline O Moses
- Department of Psychology, Florida International University, United States
| | - Kelly D Cromer
- Department of Psychology, Florida International University, United States
| | - Lucybel Mendez
- Center for Children and Families, Florida International University, United States
| | - Loreen S Magariño
- Department of Psychology, Florida International University, United States
| | - Feion M Villodas
- Department of Psychology, San Diego State University, United States; Department of Psychology, Florida International University, United States; Department of Psychology, University of Utah, United States
| | - Daniel M Bagner
- Department of Psychology, Florida International University, United States; Department of Psychology, University of Utah, United States
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Chung G, Ansong D, Brevard KC, Chen DG. Identifying treatment moderators of a trauma-informed parenting intervention with children in foster care: Using model-based recursive partitioning. CHILD ABUSE & NEGLECT 2021; 117:105065. [PMID: 33853021 DOI: 10.1016/j.chiabu.2021.105065] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 03/01/2021] [Accepted: 03/31/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Trauma-informed parenting interventions have been used in child welfare to help caregivers respond to children in trauma-informed ways that can mitigate the effects of maltreatment and build strong caregiver-child relationships. Existing studies support their effectiveness with children and youth involved in the child welfare system. However, to further advance the effectiveness of evidenced-based intervention for child welfare populations, one key step is to identify subgroups of individuals who have different intervention responses or outcomes. OBJECTIVE To identify pre-treatment moderators that can distinguish subgroups of caregivers and children who benefit differently from an intervention. PARTICIPANTS AND SETTING 414 children in foster care (age 3 or younger) and their caregivers (birth, adoptive, kin, and nonkin) were randomly assigned to receive a trauma-informed parenting intervention in the Illinois Birth through Three Title IV-E waiver demonstration or foster care services as usual. METHODS Model-based Recursive Partitioning (MOB) was used to identify treatment moderators and moderator interactions. MOB fits a parametric model and uses a data-driven method to find subgroups for which the specified parametric model has different parameters. Two parametric models (logistic and linear regression) were used in accordance with two outcomes: reunification (binary) and caregiver-child attachment (continuous). We examined 21 potential pre-treatment moderators in both models. RESULTS For the reunification outcome, the MOB produced the following three treatment moderators, which identified subgroups of participants who responded differently to the intervention: (a) caregivers' relationship with the child (kin vs. non-kin/permanent caregivers), (b) caregiver-child attachment, and (c) case history of physical abuse. For the attachment outcome, caregivers' age was found to be a treatment moderator. Future developments of trauma-informed interventions should consider these moderators.
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Affiliation(s)
- Gerard Chung
- School of Social Work, University of North Carolina at Chapel Hill, USA.
| | - David Ansong
- School of Social Work, University of North Carolina at Chapel Hill, USA
| | - Kanisha C Brevard
- School of Social Work, University of North Carolina at Chapel Hill, USA
| | - Ding-Geng Chen
- School of Social Work, University of North Carolina at Chapel Hill, USA
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Falconer MK, Randolph KA, Deichen Hansen M. A Comparison of Professional Views on Research-Supported Parenting Interventions in A Community-Based System of Care. JOURNAL OF EVIDENCE-BASED SOCIAL WORK (2019) 2020; 17:406-426. [PMID: 32692640 DOI: 10.1080/26408066.2020.1753613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
PURPOSE This qualitative study examined views of research-supported parenting interventions across three stakeholder groups that have critical roles in child welfare-case managers, clinicians, and judicial representatives in one rural community. METHOD Semi-structured interviews were conducted with members in each stakeholder group. Two analytic approaches were used. First, views on the selection of research-supported interventions, strengths and weaknesses, and professional collaboration in implementation were examined. Second, several factors in the literature impacting research-supported interventions were used to compare views. RESULTS All stakeholder groups supported the use of research-supported therapies while agreeing that the overriding importance in selecting any therapy was to ensure the best "fit" with a client. Professional collaboration was considered essential in a variety of forms and combinations by all groups. DISCUSSION AND CONCLUSION The results highlight important considerations in selecting and implementing research-supported parent therapies. Recommendations to continue and expand this line of research are articulated.
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Affiliation(s)
| | - Karen A Randolph
- Florida State University College of Social Work , Tallahassee, Florida, USA
| | - Megan Deichen Hansen
- Department of Behavioral Sciences and Social Medicine, Florida State University College of Medicine , Tallahassee, Florida, USA
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Döpfner M, Katzmann J, Hanisch C, Fegert JM, Kölch M, Ritschel A, Treier AK, Hellmich M, Roessner V, Ravens-Sieberer U, Banaschewski T, Görtz-Dorten A. Affective dysregulation in childhood - optimizing prevention and treatment: protocol of three randomized controlled trials in the ADOPT study. BMC Psychiatry 2019; 19:264. [PMID: 31477086 PMCID: PMC6720991 DOI: 10.1186/s12888-019-2239-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Accepted: 08/14/2019] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND The terms affective dysregulation (AD) and irritability describe transdiagnostic dimensions and are characterized by an excessive reactivity to negative emotional stimuli with an affective (anger) and a behavioral component (aggression). Due to early onset, high prevalence and persistence, as well as developmental comorbidity, AD in childhood is one of the most psychosocially impairing and cost-intensive mental health conditions. AD is especially prevalent in children in the youth welfare service. Despite continuous research, there remains a substantial need for diagnostic approaches and optimization of individualized treatment strategies in order to improve outcomes and reduce the subjective and economic burden. METHODS The ADOPT (Affective Dysregulation - Optimizing Prevention and Treatment) Consortium integrates internationally established, highly experienced and interdisciplinary research groups. The work program encompasses (a) epidemiology, including prevalence of symptoms and disorders, (b) development and evaluation of screening and assessment tools, (c) stepped care approaches for clinically useful personalized medicine, (d) evaluation of an easily accessible and cost-effective online intervention as indicated prevention (treatment effects, moderation/mediation analysis), and (e) evaluation of an intensive personalized modular outpatient treatment in a cohort of children with AD who live with their parents and in a cohort of children with AD who live in out-of-home care (treatment effects, moderation/mediation analysis). DISCUSSION The results will lead to significant recommendations for improving treatment within routine clinical care in two cohorts of children with AD and coexisting conditions, especially oppositional-defiant disorder, conduct disorder and disruptive mood dysregulation disorder. TRIAL REGISTRATION Trial registration ADOPT Online: German Clinical Trials Register (DRKS) DRKS00014963 . Registered 27 June 2018. Trial registration ADOPT Treatment: German Clinical Trials Register (DRKS) DRKS00013317 . Registered 27 September 2018. Trial registration ADOPT Institution: German Clinical Trials Register (DRKS) DRKS00014581 . Registered 04 July 2018.
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Affiliation(s)
- Manfred Döpfner
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Medical Faculty of the University of Cologne, Cologne, Germany. .,School for Child and Adolescent Cognitive Behavior Therapy (AKiP), Medical Faculty of the University of Cologne, Pohligstraße 9, 50969, Cologne, Germany.
| | - Josepha Katzmann
- 0000 0000 8580 3777grid.6190.eDepartment of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Medical Faculty of the University of Cologne, Cologne, Germany ,0000 0000 8580 3777grid.6190.eSchool for Child and Adolescent Cognitive Behavior Therapy (AKiP), Medical Faculty of the University of Cologne, Pohligstraße 9, 50969 Cologne, Germany
| | - Charlotte Hanisch
- 0000 0000 8580 3777grid.6190.eFaculty of Human Sciences, University of Cologne, Cologne, Germany
| | - Jörg M. Fegert
- 0000 0004 1936 9748grid.6582.9Department of Child and Adolescent Psychiatry/Psychotherapy, University of Ulm, Ulm, Germany
| | - Michael Kölch
- 0000 0004 1936 9748grid.6582.9Department of Child and Adolescent Psychiatry/Psychotherapy, University of Ulm, Ulm, Germany ,Department of Child and Adolescent Psychiatry and Psychotherapy, Brandenburg Medical School Brandenburg, Neuruppin, Germany ,Department of Child and Adolescent Psychiatry, Neurology, Psychosomatics, and Psychotherapy, University Medical Center Rostock, Rostock, Germany
| | - Anne Ritschel
- 0000 0000 8580 3777grid.6190.eFaculty of Human Sciences, University of Cologne, Cologne, Germany
| | - Anne-Katrin Treier
- 0000 0000 8580 3777grid.6190.eDepartment of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Medical Faculty of the University of Cologne, Cologne, Germany ,0000 0000 8580 3777grid.6190.eSchool for Child and Adolescent Cognitive Behavior Therapy (AKiP), Medical Faculty of the University of Cologne, Pohligstraße 9, 50969 Cologne, Germany
| | - Martin Hellmich
- 0000 0000 8580 3777grid.6190.eInstitute of Medical Statistics and Computational Biology (IMSB), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Veit Roessner
- 0000 0001 2111 7257grid.4488.0Department of Child and Adolescent Psychiatry and Psychotherapy, TU Dresden, Dresden, Germany
| | - Ulrike Ravens-Sieberer
- 0000 0001 2180 3484grid.13648.38Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics & Research Unit Child Public Health, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Tobias Banaschewski
- 0000 0001 2190 4373grid.7700.0Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Anja Görtz-Dorten
- 0000 0000 8580 3777grid.6190.eDepartment of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Medical Faculty of the University of Cologne, Cologne, Germany ,0000 0000 8580 3777grid.6190.eSchool for Child and Adolescent Cognitive Behavior Therapy (AKiP), Medical Faculty of the University of Cologne, Pohligstraße 9, 50969 Cologne, Germany
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Ek A, Chamberlain KL, Sorjonen K, Hammar U, Malek ME, Sandvik P, Somaraki M, Nyman J, Lindberg L, Nordin K, Ejderhamn J, Fisher PA, Chamberlain P, Marcus C, Nowicka P. A Parent Treatment Program for Preschoolers With Obesity: A Randomized Controlled Trial. Pediatrics 2019; 144:peds.2018-3457. [PMID: 31300528 PMCID: PMC8853645 DOI: 10.1542/peds.2018-3457] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/07/2019] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Early obesity treatment seems to be the most effective, but few treatments exist. In this study, we examine the effectiveness of a parent-only treatment program with and without booster sessions (Booster or No Booster) focusing on parenting practices and standard treatment (ST). METHODS Families of children 4 to 6 years of age with obesity were recruited from 68 child care centers in Stockholm County and randomly assigned to a parent-only program (10 weeks) with or without boosters (9 months) or to ST. Treatment effects on primary outcomes (BMI z score) and secondary outcomes (BMI and waist circumference) during a 12-month period were examined with linear mixed models. The influence of sociodemographic factors was examined by 3-way interactions. The clinically significant change in BMI z score (-0.5) was assessed with risk ratios. RESULTS A total of 174 children (mean age: 5.3 years [SD = 0.8]; BMI z score: 3.0 [SD = 0.6], 56% girls) and their parents (60% foreign background; 39% university degree) were included in the analysis (Booster, n = 44; No Booster, n = 43; ST, n = 87). After 12 months, children in the parent-only treatment had a greater reduction in their BMI z score (0.30; 95% confidence interval [CI]: -0.45 to -0.15) compared with ST (0.07; 95% CI: -0.19 to 0.05). Comparing all 3 groups, improvements in weight status were only seen for the Booster group (-0.54; 95% CI: -0.77 to -0.30). The Booster group was 4.8 times (95% CI: 2.4 to 9.6) more likely to reach a clinically significant reduction of ≥0.5 of the BMI z score compared with ST. CONCLUSION A parent-only treatment with boosters outperformed standard care for obesity in preschoolers.
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Affiliation(s)
- Anna Ek
- Division of Pediatrics, Department of Clinical Science, Intervention, and Technology,
| | | | - Kimmo Sorjonen
- Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Solna, Sweden
| | - Ulf Hammar
- Department of Biostatistics, Institute of Environmental Medicine, Karolinska Institutet, Solna, Sweden,Section of Molecular Epidemiology, Departments of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Mahnoush Etminan Malek
- Department of Public Health Sciences, Karolinska Institutet, Solna, Sweden,Astrid Lindgren Children’s Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - Pernilla Sandvik
- Division of Pediatrics, Department of Clinical Science, Intervention, and Technology, Karolinska University Hospital, Stockholm, Sweden,Food Studies, Nutrition, and Dietetics, Uppsala University, Uppsala, Sweden
| | - Maria Somaraki
- Food Studies, Nutrition, and Dietetics, Uppsala University, Uppsala, Sweden
| | - Jonna Nyman
- Astrid Lindgren Children’s Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - Louise Lindberg
- Division of Pediatrics, Department of Clinical Science, Intervention, and Technology, Karolinska University Hospital, Stockholm, Sweden
| | - Karin Nordin
- Division of Pediatrics, Department of Clinical Science, Intervention, and Technology, Karolinska University Hospital, Stockholm, Sweden
| | - Jan Ejderhamn
- Astrid Lindgren Children’s Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - Philip A. Fisher
- Oregon Social Learning Center, Eugene, Oregon,Department of Psychology, University of Oregon, Eugene, Oregon
| | | | - Claude Marcus
- Division of Pediatrics, Department of Clinical Science, Intervention, and Technology, Karolinska University Hospital, Stockholm, Sweden
| | - Paulina Nowicka
- Division of Pediatrics, Department of Clinical Science, Intervention, and Technology, Karolinska University Hospital, Stockholm, Sweden,Food Studies, Nutrition, and Dietetics, Uppsala University, Uppsala, Sweden
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11
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Ek A, Delisle Nyström C, Chirita-Emandi A, Tur JA, Nordin K, Bouzas C, Argelich E, Martínez JA, Frost G, Garcia-Perez I, Saez M, Paul C, Löf M, Nowicka P. A randomized controlled trial for overweight and obesity in preschoolers: the More and Less Europe study - an intervention within the STOP project. BMC Public Health 2019; 19:945. [PMID: 31307412 PMCID: PMC6631737 DOI: 10.1186/s12889-019-7161-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Accepted: 06/13/2019] [Indexed: 12/15/2022] Open
Abstract
Background Childhood overweight and obesity is a serious public health issue with an increase being observed in preschool-aged children. Treating childhood obesity is difficult and few countries use standardized treatments. Therefore, there is a need to find effective approaches that are feasible for both health care providers and families. Thus, the overall aim of this study is to assess the acceptance and effectiveness of a parent support program (the More and Less, ML) for the management of overweight and obesity followed by a mobile health (mHealth) program (the MINISTOP application) in a socially diverse population of families. Methods/design A two-arm, parallel design randomized controlled trial in 300 2-to 6-year-old children with overweight and obesity from Romania, Spain and Sweden (n = 100 from each). Following baseline assessments children are randomized into the intervention or control group in a 1:1 ratio. The intervention, the ML program, consists of 10-weekly group sessions which focus on evidence-based parenting practices, followed by the previously validated MINISTOP application for 6-months to support healthy eating and physical activity behaviors. The primary outcome is change in body mass index (BMI) z-score after 9-months and secondary outcomes include: waist circumference, eating behavior (Child Eating Behavior Questionnaire), parenting behavior (Comprehensive Feeding Practices Questionnaire), physical activity (ActiGraph wGT3x-BT), dietary patterns (based on metabolic markers from urine and 24 h dietary recalls), epigenetic and gut hormones (fasting blood samples), and the overall acceptance of the overweight and obesity management in young children (semi-structured interviews). Outcomes are measured at baseline and after: 10-weeks (only BMI z-score, waist circumference), 9-months (all outcomes), 15- and 21-months (all outcomes except physical activity, dietary patterns, epigenetics and gut hormones) post-baseline. Discussion This study will evaluate a parent support program for weight management in young children in three European countries. To boost the effect of the ML program the families will be supported by an app for 6-months. If the program is found to be effective, it has the potential to be implemented into routine care to reduce overweight and obesity in young children and the app could prove to be a viable option for sustained effects of the care provided. Trial registration ClinicalTrials.gov NCT03800823; 11 Jan 2019.
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Affiliation(s)
- Anna Ek
- Division of Pediatrics, Department of Clinical Science Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.
| | | | - Adela Chirita-Emandi
- Genetics Department, University of Medicine and Pharmacy "Victor Babes", Timisoara, Romania.,"Louis Turcanu" Clinical Emergency Hospital for Children, Timisoara, Romania
| | - Josep A Tur
- Research Group on Community Nutrition & Oxidative Stress, University of the Balearic Islands, Palma de Mallorca, Spain.,CIBER of Physiology of Obesity and Nutrition (CIBEROBN), Instituto Carlos III, Madrid, Spain
| | - Karin Nordin
- Division of Pediatrics, Department of Clinical Science Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - Cristina Bouzas
- Research Group on Community Nutrition & Oxidative Stress, University of the Balearic Islands, Palma de Mallorca, Spain.,CIBER of Physiology of Obesity and Nutrition (CIBEROBN), Instituto Carlos III, Madrid, Spain
| | - Emma Argelich
- Research Group on Community Nutrition & Oxidative Stress, University of the Balearic Islands, Palma de Mallorca, Spain.,CIBER of Physiology of Obesity and Nutrition (CIBEROBN), Instituto Carlos III, Madrid, Spain
| | - J Alfredo Martínez
- CIBER of Physiology of Obesity and Nutrition (CIBEROBN), Instituto Carlos III, Madrid, Spain.,Department of Nutrition, Food Science, and Physiology, Centre for Nutrition Research, University of Navarra, Pamplona, Spain.,IMDEA Food Precision Nutrition, Madrid, Spain
| | - Gary Frost
- Section for Nutrition Research, Department of Medicine, Imperial College London, Hammersmith Campus, London, UK
| | - Isabel Garcia-Perez
- Division of Systems and Digestive Medicine, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, South Kensington Campus, London, UK
| | - Marc Saez
- Research Group on Statistics, Econometrics and Health (GRECS), University of Girona, Campus de Montilivi, Girona, Spain.,CIBER of Epidemiology and Public Health (CIBERESP), Instituto Carlos III, Madrid, Spain
| | - Corina Paul
- Pediatrics Department, University of Medicine and Pharmacy "Victor Babes", Timisoara, Romania.,2nd Pediatrics Clinic, Clinical Emergency County Hospital Timisoara, Timisoara, Romania
| | - Marie Löf
- Department of Biosciences and Nutrition, Karolinska Institutet, Stockholm, Sweden.,Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
| | - Paulina Nowicka
- Division of Pediatrics, Department of Clinical Science Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.,Department of Food Studies, Nutrition, and Dietetics, Uppsala University, Uppsala, Sweden
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12
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Colvin ML, Thompson HM. Exploring the Experiences of Child Welfare-Focused Therapeutic Service Providers. J Behav Health Serv Res 2019; 47:86-101. [PMID: 30887414 PMCID: PMC7224150 DOI: 10.1007/s11414-019-09654-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The importance of mental and behavioral health for child welfare clients is well-documented; yet, little is known about the challenges therapeutic service providers (TSPs) experience working in child welfare practice. To explore this topic, five focus groups were conducted with 40 TSPs in a contracted mental and behavioral health agency and data were analyzed following an inductive thematic process. Eleven primary challenges were identified, including the difficulty of navigating numerous involved parties, an overwhelmed work environment, legal intersections common to child welfare cases, unrealistic agency expectations, and heighten case complexity when working with child welfare populations. Findings are organized across system, agency, and client levels and add to the understanding of TSP perspectives working with child welfare. Targeted interventions are discussed, such as efforts to promote realistic expectations and training strategies, as well as directions for future research to improve the intersection between child welfare and mental and behavioral health.
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Affiliation(s)
- Marianna L Colvin
- School of Social Work, SO303, Florida Atlantic University, 777 Glades Rd, Boca Raton, FL, 33431, USA.
| | - Heather M Thompson
- School of Social Work, SO303, Florida Atlantic University, 777 Glades Rd, Boca Raton, FL, 33431, USA
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13
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Maltais C, Cyr C, Parent G, Pascuzzo K. Identifying effective interventions for promoting parent engagement and family reunification for children in out-of-home care: A series of meta-analyses. CHILD ABUSE & NEGLECT 2019; 88:362-375. [PMID: 30579168 DOI: 10.1016/j.chiabu.2018.12.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Revised: 12/06/2018] [Accepted: 12/10/2018] [Indexed: 05/22/2023]
Abstract
BACKGROUND An important obstacle for family reunification following child placement in residential care and other temporary out-of-home care services is the lack of engagement among parents. OBJECTIVE The aim of this meta-analysis is to identify the most effective interventions to promote parental engagement and family reunification. METHOD AND PARTICIPANTS Eight studies, for a total of 2996 families, were used to conduct two series of meta-analyses. Each study examined the effectiveness of a goal-oriented parental engagement intervention, relative to a control group made up of parents who received standard services. Six moderators were analyzed: type of clinical modality, number of clinical strategies, sources of motivation for intervention, focus on the child care staff-parent relationship, child care staff training, and strategies to promote access to intervention. RESULTS Results indicate that parents exposed to goal-oriented engagement interventions showed greater engagement (effect size d = 0.71, CI: 0.35-1.07, p < 0.001) and likelihood of reunification (effect size OR = 2.49, CI: 1.22-5.10, p < 0.05) than parents who received standard services. In particular, moderator analysis showed that parents who specifically participated in a family-focused intervention showed the highest engagement in comparison to parents involved in other types of interventions or who received standard services (effect size d = 1.08, CI: 0.58-1.59, p < 0.001). No moderators significantly explained heterogeneity of studies on family reunification. CONCLUSION Overall, the results underline the effectiveness of family-focused interventions to promote parental engagement. Nevertheless, greater knowledge on the mechanisms by which interventions can increase parents' engagement and family reunification is still needed.
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Affiliation(s)
- Christine Maltais
- Unité d'évaluation des technologies et des modes d'intervention, Direction de l'enseignement universitaire et de la recherché, Centre intégré universitaire de santé et services sociaux du Centre-Sud-de-l'île-de-Montréal, 4565 Queen Mary, Montreal, Québe H3W 1W5, Canada.
| | - Chantal Cyr
- Département de psychologie, Université du Québec à Montréal, Québec, Canada
| | - Geneviève Parent
- Département de psychoéducation et de psychologie, Université du Québec en Outaouais, Québec, Canada
| | - Katherine Pascuzzo
- Département de psychologie, Université du Québec à Montréal, Québec, Canada; Institut universitaire jeunes en difficulté, Centre intégré universitaire de santé et services sociaux du Centre-Sud-de-l'île-de-Montréal, Québec, Canada
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14
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Pasalich DS, Fleming CB, Spieker SJ, Lohr MJ, Oxford ML. Does Parents' Own History of Child Abuse Moderate the Effectiveness of the Promoting First Relationships® Intervention in Child Welfare? CHILD MALTREATMENT 2019; 24:56-65. [PMID: 30428707 DOI: 10.1177/1077559518809217] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
To better understand how and for whom parenting intervention may improve family outcomes in child welfare services, we examined whether parents' own history of child abuse moderated the indirect effects of the Promoting First Relationships® (PFR) intervention on toddlers' secure base behavior via parental sensitivity. Parents ( N = 247) and their toddlers (10-24 months) involved with child protective services were randomized to PFR or a control intervention. Results showed that the PFR group demonstrated greater parental sensitivity at postintervention than the control group, which in turn led to higher levels of toddler secure base behavior at 6-month follow-up. Findings from a moderated mediation model indicated that these intervention effects were only evident for parents who experienced physical abuse in their childhood. Parents' history of sexual or emotional abuse did not significantly moderate outcomes. These results provide evidence for a key mechanism of change in PFR informed by attachment theory and suggest that PFR intervention effects may be stronger in parents at higher risk of the intergenerational transmission of abuse.
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15
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Akin BA, McDonald TP. Parenting intervention effects on reunification: A randomized trial of PMTO in foster care. CHILD ABUSE & NEGLECT 2018; 83:94-105. [PMID: 30025308 DOI: 10.1016/j.chiabu.2018.07.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Revised: 06/20/2018] [Accepted: 07/08/2018] [Indexed: 06/08/2023]
Abstract
Evidence-supported parenting interventions (ESPIs) have expanded into child welfare because a growing research base has demonstrated positive results among children with serious emotional and behavioral problems. Despite a clear federal policy emphasis on reunification, few randomized trials have tested ESPIs with biological families of children in foster care; even fewer studies have investigated the distal outcomes of ESPIs. The aim of the current study was to examine the effects of Parent Management Training, Oregon (PMTO) model on reunification. Children in foster care with emotional and behavioral problems were randomized to in-home PMTO (n = 461) or services as usual (SAU) (n = 457). Cox regression models tested whether children in the PMTO group achieved higher rates of reunification. We applied life tables data for integrals calculations to estimate days saved in foster care. Analyses were conducted as intent-to-treat (ITT), and per protocol analysis (PPA). ITT results showed reunification rates were 6.9% higher for the PMTO group (62.7%) than the SAU group (55.8%) with 151 days saved per typical child. PPA indicated that intervention completion strengthened effects as PMTO completers' reunification rates (69.5%) were 13.7% higher than the SAU group (55.8%), and were 15.3% higher than non-completers (54.2%). Days saved were also greater for completers as compared to the SAU group (299 days) and non-completers (358 days). Overall, findings suggest that an in-home parenting intervention positively affected reunification as delivered to biological parents of children and youth in foster care with serious emotional and behavioral problems. Implications and future considerations for research are discussed.
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Affiliation(s)
- Becci A Akin
- University of Kansas School of Social Welfare, Twente Hall, 1545 Lilac Lane, Lawrence, KS 66044, USA.
| | - Thomas P McDonald
- University of Kansas School of Social Welfare, Twente Hall, 1545 Lilac Lane, Lawrence, KS 66044, USA
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16
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Predictive Value of Parent-Professional Alliance for Outcomes of Home-Based Parenting Support. CHILD & YOUTH CARE FORUM 2018. [DOI: 10.1007/s10566-018-9467-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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17
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Özyurt G, Dinsever Ç, Çaliskan Z, Evgin D. Can positive parenting program (Triple P) be useful to prevent child maltreatment? Indian J Psychiatry 2018; 60:286-291. [PMID: 30405253 PMCID: PMC6201675 DOI: 10.4103/psychiatry.indianjpsychiatry_92_17] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE This study aimed to determine the effect of the positive parenting program (Triple P) on child maltreatment, children's behaviors, and coping strategies of mothers. MATERIALS AND METHODS This study was the pretest-posttest quasiexperimental design. Secondary care state hospital located in the Cappadocia region between January and February 2016. This study was conducted with mothers (n: 138) of children aged between 4 and 12 years, 126 mothers were available to finish the study. Triple P was provided to the mothers in totally three sessions as once per a week. Mothers filled the scales and parent-child information form before the intervention and just after the intervention. Parent-child information form, child behavior checklist, and ways of coping inventory were administered to the mothers. RESULTS It was determined that after the training, mean scores obtained by the children from the subscales of anxiety, social problems, somatic complaints, attention problems, rule-breaking, and aggressive behaviors decreased (P < 0.05) and desperate approach and submissive approach mean scores of the mothers decreased (P < 0.001) whereas their social support mean scores increased (P < 0.05). In addition, the mothers, who stated that they were frequently looking angry (17.4%), yelling (24.6%), sometimes humiliating (27.7%) to their children, and injured their faces (6.3%) in the past 1 month, said that they did these behaviors to their children at lower rate at the end of the training (3.9%, 17.4%, 19.8%, and 0.0%, respectively). CONCLUSIONS It was determined that Triple P was effective in reducing children's behavioral problems and improving mothers' strategies of coping with stress and contributed the reduction of emotional and physical abuse applied to children. It is recommended to ensure the continuity of these training programs.
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Affiliation(s)
- Gonca Özyurt
- Department of Child and Adolescent Psychiatry, Medical School, Katip Çelebi University, Izmir, Turkey
| | - Çagla Dinsever
- Child and Adolescent Psychiatry Department, Child Psychology Nevsehir State Hospital, Child Development Polyclinic, Nevşehir, Turkey
| | - Zehra Çaliskan
- Child Development Unit, Semra and Vefa Küçük Health College, Nevsehir Haci Bektas Veli University, Nevşehir, Turkey
| | - Derya Evgin
- Child Development Unit, Semra and Vefa Küçük Health College, Nevsehir Haci Bektas Veli University, Nevşehir, Turkey
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18
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Temcheff CE, Letarte MJ, Boutin S, Marcil K. Common components of evidence-based parenting programs for preventing maltreatment of school-age children. CHILD ABUSE & NEGLECT 2018; 80:226-237. [PMID: 29631254 DOI: 10.1016/j.chiabu.2018.02.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Revised: 02/01/2018] [Accepted: 02/06/2018] [Indexed: 06/08/2023]
Abstract
Child maltreatment can lead to a variety of negative outcomes in childhood including physical and mental health problems that can extend into adulthood. Given the transactional nature of child maltreatment and the difficulties that many maltreating families experience, child protection services typically offer various kinds of programs to maltreated children, their parents, and/or their families. Although the specific difficulties experienced by these families may vary, sub-optimal parenting practices are typically part of the picture and may play a central role in maltreated children's development. Hence, to deal with child maltreatment, programs that focus on parenting practices are essential, and identifying the common components of effective programs is of critical importance. The objectives of the present study were to: 1) describe the components of evidence-based parenting programs aimed at parents who have maltreated their elementary school-aged children or are at-risk for doing so and 2) identify the components that are common to these programs, using the approach proposed by Barth and Liggett-Creel (2014). Fourteen evidence-based parenting programs aimed at parents who had maltreated their elementary school-aged children (ages 6-12) or were at-risk for doing so were identified using both a review of relevant online databases of evidence-based programs (California Evidence-Based Clearinghouse for Child Welfare, Blueprints for Healthy Youth Development, Youth.gov, and the National Registry of Evidence-based Programs and Practices). Common components were identified (operationalized as components present in two thirds of programs) and discussed. The identification of common components of evidence-based programs may help clinicians choose the best intervention methods.
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Affiliation(s)
- Caroline E Temcheff
- Department of Educational and Counselling Psychology, McGill Univeristy, Canada.
| | | | - Stéphanie Boutin
- Department of Educational and Counselling Psychology, McGill Univeristy, Canada
| | - Katherine Marcil
- Département de psychoeducation, Université de Sherbrooke, Canada
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19
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Toward Creating Synergy Among Policy, Procedures, and Implementation of Evidence-Based Models in Child Welfare Systems: Two Case Examples. Clin Child Fam Psychol Rev 2018; 20:78-86. [PMID: 28236157 DOI: 10.1007/s10567-017-0226-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Over the past four to five decades, multiple randomized controlled trials have verified that preventive interventions targeting key parenting skills can have far-reaching effects on improving a diverse array of child outcomes. Further, these studies have shown that parenting skills can be taught, and they are malleable. Given these advances, prevention scientists are in a position to make solid empirically based recommendations to public child service systems on using parent-mediated interventions to optimize positive outcomes for the children and families that they serve. Child welfare systems serve some of this country's most vulnerable children and families, yet they have been slow (compared to juvenile justice and mental health systems) to adopt empirically based interventions. This paper describes two child-welfare-initiated, policy-based case studies that have sought to scale-up research-based parenting skills into the routine services that caseworkers deliver to the families that they serve. In both case studies, the child welfare system leaders worked with evaluators and model developers to tailor policy, administrative, and fiscal system practices to institutionalize and sustain evidence-based practices into usual foster care services. Descriptions of the implementations, intervention models, and preliminary results are described.
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20
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Landers AL, McLuckie A, Cann R, Shapiro V, Visintini S, MacLaurin B, Trocmé N, Saini M, Carrey NJ. A scoping review of evidence-based interventions available to parents of maltreated children ages 0-5 involved with child welfare services. CHILD ABUSE & NEGLECT 2018; 76:546-560. [PMID: 28985958 DOI: 10.1016/j.chiabu.2017.09.012] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2017] [Revised: 09/05/2017] [Accepted: 09/10/2017] [Indexed: 06/07/2023]
Abstract
Parents referred to child welfare services for child maltreatment often struggle against chronic risk factors including violence, substance abuse, mental health concerns, and poverty, which impinge upon their ability to be sensitive caregivers. The first line of intervention within the child welfare context is to modify parenting behavior. This scoping review comprehensively surveyed all available literature to map the extent and range of research activity around the types of interventions available within a child welfare context to parents of infants and toddlers (0-5 years of age), to identify the facilitators and/or barriers to the uptake of interventions, and to check that interventions match the risk factors faced by parents. This scoping review engaged in stringent screening of studies based upon inclusion/exclusion criteria. Sixty-five articles involving forty-two interventions met inclusion criteria. Interventions generally aimed to improve parenting practices, the relationship between parent and child, and/or attachment security, along with reducing child abuse and/or neglect. A notable finding of this scoping review is that at present, interventions for parents of children ages 0-5 involved with the child welfare system are most frequently measured via case study and quasi-experimental designs, with randomized control trials making up 26.2% of included study designs.
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Affiliation(s)
- Ashley L Landers
- Virginia Polytechnic Institute & State University, United States.
| | | | - Robin Cann
- IWK Health Centre, Halifax, Nova Scotia, Canada
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21
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Willging CE, Aarons GA, Trott EM, Green AE, Finn N, Ehrhart MG, Hecht DB. Contracting and Procurement for Evidence-Based Interventions in Public-Sector Human Services: A Case Study. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2018; 43:675-692. [PMID: 26386977 DOI: 10.1007/s10488-015-0681-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Sustainment of evidence-based interventions (EBIs) in human services depends on the inner context of community-based organizations (CBOs) that provide services and the outer context of their broader environment. Increasingly, public officials are experimenting with contracting models from for-profit industries to procure human services. In this case study, we conducted qualitative interviews with key government and CBO stakeholders to examine implementation of the Best Value-Performance Information Procurement System to contract for EBIs in a child welfare system. Findings suggest that stakeholder relationships may be compromised when procurement disregards local knowledge, communication, collaboration, and other factors supporting EBIs and public health initiatives.
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Affiliation(s)
- Cathleen E Willging
- Pacific Institute for Research and Evaluation, Behavioral Health Research Center of the Southwest, 612 Encino Place, NE, Albuquerque, NM, 87102, USA.
| | - Gregory A Aarons
- Child and Adolescent Services Research Center, University of California, San Diego 9500 Gilman Dr. (0812), La Jolla, CA, 92093-0812, USA
| | - Elise M Trott
- Pacific Institute for Research and Evaluation, Behavioral Health Research Center of the Southwest, 612 Encino Place, NE, Albuquerque, NM, 87102, USA
| | - Amy E Green
- Child and Adolescent Services Research Center, University of California, San Diego 9500 Gilman Dr. (0812), La Jolla, CA, 92093-0812, USA
| | - Natalie Finn
- Child and Adolescent Services Research Center, University of California, San Diego 9500 Gilman Dr. (0812), La Jolla, CA, 92093-0812, USA
| | - Mark G Ehrhart
- Department of Psychology, San Diego State University, 5500 Campanile Drive, San Diego, CA, 92182-4611, USA
| | - Debra B Hecht
- Section of Developmental and Behavioral Pediatrics, University of Oklahoma Health Sciences Center, 940 NE 13th Street, Nicholson Tower Suite 4900, Oklahoma City, OK, 73104, USA
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22
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Gunderson LM, Willging CE, Trott Jaramillo EM, Green AE, Fettes DL, Hect DB, Aarons GA. The good coach: implementation and sustainment factors that affect coaching as evidence-based intervention fidelity support. JOURNAL OF CHILDREN'S SERVICES 2018; 13:1-17. [PMID: 30906421 PMCID: PMC6426451 DOI: 10.1108/jcs-09-2017-0043] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
PURPOSE Evidence-based interventions (EBIs) for human services unfold within complicated social and organizational circumstances and are influenced by the attitudes and behaviors of diverse stakeholders situated within these environments. Coaching is commonly regarded as an effective strategy to support service providers in delivering EBIs and attaining high levels of fidelity over time. The purpose of this paper is to address a lacuna in research examining the factors influencing coaching, an important EBI support component. METHODOLOGY The authors use the Exploration, Preparation, Implementation, and Sustainment framework to consider inner- and outer-context factors that affect coaching over time. This case study of coaching draws from a larger qualitative data set from three iterative investigations of implementation and sustainment of a home visitation program, SafeCare®. SafeCare is an EBI designed to reduce child neglect. FINDINGS The authors elaborate on six major categories of findings derived from an iterative data coding and analysis process: perceptions of "good" and "bad" coaches by system sustainment status; coach as peer; in-house coaching capacity; intervention developer requirements vs other outer-context needs; outer- context support; and inner-context support. PRACTICAL IMPLICATIONS Coaching is considered a key component for effective implementation of EBIs in public-sector systems, yet is under-studied. Understanding inner- and outer-context factors illuminates the ways they affect the capacity of coaches to support service delivery. ORIGINALITY This paper demonstrates that coaching can accomplish more than provision of EBI fidelity support. Stakeholders characterized coaches as operating as boundary spanners who link inner and outer contexts to enable EBI implementation and sustainment.
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Affiliation(s)
- Lara M Gunderson
- Behavioral Health Research Center of the Southwest, Pacific Institute for Research and Evaluation, Albuquerque, New Mexico, USA
| | - Cathleen E Willging
- Behavioral Health Research Center of the Southwest, Pacific Institute for Research and Evaluation, Albuquerque, New Mexico, USA
| | - Elise M Trott Jaramillo
- Behavioral Health Research Center of the Southwest, Pacific Institute for Research and Evaluation, Albuquerque, New Mexico, USA
| | - Amy E Green
- Child and Adolescent Services Research Center, University of California, San Diego, California, USA
| | - Danielle L Fettes
- Child and Adolescent Services Research Center, University of California, San Diego, California, USA
| | - Debra B Hect
- Developmental and Behavioral Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Gregory A Aarons
- Child and Adolescent Services Research Center, University of California, San Diego, California, USA
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23
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Van Dongen T, Sabbe B, Glazemakers I. A protocol for interagency collaboration and family participation: Practitioners' perspectives on the Client Network Consultation. J Interprof Care 2017; 32:14-23. [PMID: 29058496 DOI: 10.1080/13561820.2017.1379961] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Interagency collaboration has many advantages, but seems hard to realise in practice. In Belgium, the need for collaboration between the practitioners in the field of child welfare and child psychiatry, especially for children and adolescents with complex health care needs, was identified. Children with complex health care needs require coordinated care and collaboration between the different sectors in child mental health care (child welfare, child psychiatry, disability care). The authors have developed a standardised protocol based on the wraparound principles, which support interagency collaboration with family participation, named Client Network Consultation (CNC). Focus groups evaluated the CNC by eliciting practitioners' views on the structure, content and impact of collaborative interagency protocols with family involvement. Thematic analysis revealed four core themes: (1) Empowering the child and the family; (2) Utilising the strength of the collective; (3) Being considerate versus constructive a dilemma for participants in CNC; and (4) The structure of a protocol offers opportunities and challenges. Results of the study offer implications for daily practice. Several challenges for interprofessional (IP) practice in the complex field of child and adolescent mental health care are described. The value of the CNC protocol to engage families in a clinical process is also discussed.
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Affiliation(s)
- Thirsa Van Dongen
- a Faculteit geneeskunde en gezondheidswetenschappen, Collaborative Antwerp Psychiatric Research Institute , Universiteit Antwerpen , Universiteitsplein 1, Wilrijk 2610 , Belgium
| | - Bernard Sabbe
- a Faculteit geneeskunde en gezondheidswetenschappen, Collaborative Antwerp Psychiatric Research Institute , Universiteit Antwerpen , Universiteitsplein 1, Wilrijk 2610 , Belgium
| | - Inge Glazemakers
- a Faculteit geneeskunde en gezondheidswetenschappen, Collaborative Antwerp Psychiatric Research Institute , Universiteit Antwerpen , Universiteitsplein 1, Wilrijk 2610 , Belgium
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Willging CE, Trott EM, Fettes D, Gunderson L, Green AE, Myers R, Hurlburt MS, Aarons GA. Research-Supported Intervention and Discretion Among Frontline Workers Implementing Home Visitation Services. RESEARCH ON SOCIAL WORK PRACTICE 2017; 27:664-675. [PMID: 28947872 PMCID: PMC5609484 DOI: 10.1177/1049731515601897] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
OBJECTIVE We examine how frontline workers and supervisors delivering a research supported intervention (RSI) to reduce child neglect negotiated system-related challenges, the pragmatics of RSI implementation, and their professional identities and relationships with clients. METHODS We conducted semi-structured interviews, small group discussions, and focus groups with frontline workers and supervisors in one large county over two time periods. We used iterative coding to analyze qualitative data. RESULTS Frontline workers navigated several aspects of RSI implementation and sustainment: (1) contract requirements and information dissemination, (2) fidelity, (3) competing demands and crises, (4) structure versus creativity, and (5) relationships with clients. CONCLUSIONS Workers dynamically negotiated multiple system- and provider-level (or outer- and inner-contextual) demands influencing RSI provision for clients with complex service needs. Results affirm the need to attend to the unintended consequences of implementing new contract, reimbursement, and other system organizational processes and to address the "committed work" supporting RSI delivery.
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Affiliation(s)
- Cathleen E Willging
- Pacific Institute for Research and Evaluation, Behavioral Health Research Center of the Southwest, Albuquerque, NM, USA
| | - Elise M Trott
- Pacific Institute for Research and Evaluation, Behavioral Health Research Center of the Southwest, Albuquerque, NM, USA
| | - Danielle Fettes
- Child and Adolescent Services Research Center, University of California, San Diego, CA, USA
| | - Lara Gunderson
- Pacific Institute for Research and Evaluation, Behavioral Health Research Center of the Southwest, Albuquerque, NM, USA
| | - Amy E Green
- Child and Adolescent Services Research Center, University of California, San Diego, CA, USA
| | - Roseann Myers
- County of San Diego Health and Human Services Agency, Child Welfare Services, San Diego, CA, USA
| | - Michael S Hurlburt
- School of Social Work, University of Southern California, San Diego, CA, USA
| | - Gregory A Aarons
- Child and Adolescent Services Research Center, University of California, San Diego, CA, USA
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Palinkas LA, Saldana L, Chou CP, Chamberlain P. Use of Research Evidence and Implementation of Evidence-Based Practices in Youth-Serving Systems. CHILDREN AND YOUTH SERVICES REVIEW 2017; 83:242-247. [PMID: 29170572 PMCID: PMC5695711 DOI: 10.1016/j.childyouth.2017.11.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Although the effectiveness of interventions for prevention and treatment of mental health and behavioral problems in abused and neglected youth is demonstrated through the accumulation of evidence through rigorous and systematic research, it is uncertain whether use of research evidence (URE) by child-serving systems leaders increases the likelihood of evidence- based practice (EBP) implementation and sustainment. Information on URE was collected from 151 directors and senior administrators of child welfare, mental health and juvenile justice systems in 40 California and 11 Ohio counties participating in an RCT of the use of community development teams (CDTs) to scale up implementation of Treatment Foster Care Oregon over a 3 year period (2010-12). Separate multivariate models were used to assess independent effects of evidence acquisition (input), evaluation (process), application (output), and URE in general (SIEU Total) on two measures of EBP implementation, highest stage reached and proportion of activities completed at pre-implementation, implementation and sustainment phases. Stage of implementation and proportion of activities completed in the implementation and sustainment phases were independently associated with acquisition of evidence and URE in general. Participation in CDTs was significantly associated with URE in general and acquisition of research evidence in particular. Implementation of EBPs for treatment of abused and neglected youth does appear to be associated with use of research evidence, especially during the later phases.
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Affiliation(s)
- Lawrence A. Palinkas
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles CA
| | | | - Chih-Ping Chou
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA
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McDonald T, Bhattarai J, Akin B. Predictors of Consent in a Randomized Field Study in Child Welfare. ACTA ACUST UNITED AC 2017; 14:243-265. [PMID: 28486033 DOI: 10.1080/23761407.2017.1319774] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
PURPOSE Randomized controlled trials (RCTs) are often viewed as the "gold standard" for proving the efficacy and effectiveness of new interventions. However, some are skeptical of the generalizability of the findings that RCTs produce. The characteristics of those willing to participate in research studies have the potential to affect the generalizability of its findings. This study examined factors that could influence consent among families recruited to participate in a randomized field trial in a real-world child welfare setting. METHODS This study tested the Parent Management Training Oregon Model for children in foster care with serious emotional disturbance. It employed a post-randomization consent design, whereby the entire sample of eligible participants, not just those who are willing to consent to randomization, are included in the sample. Initial eligibility assessment data and data from the federally mandated reporting system for public child welfare agencies provided the pool of potential predictors of consent. Bivariate and multivariate analyses were conducted to identify statistically significant predictors of consent. RESULTS Being a dual reunification family was the most significant factor in predicting consent. Unmarried individuals, younger, female parents, cases where parental incarceration was the reason for removal and cases where the removal reason was not due to their children's behavioral problem(s) were also more likely to participate. DISCUSSION As one of the first research studies to examine predictors of consent to a randomized field study in child welfare settings, results presented here can act as a preliminary guide for conducting RCTs in child welfare settings.
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Affiliation(s)
- Tom McDonald
- a School of Social Welfare, University of Kansas , Lawrence , Kansas , USA
| | - Jackie Bhattarai
- a School of Social Welfare, University of Kansas , Lawrence , Kansas , USA
| | - Becci Akin
- a School of Social Welfare, University of Kansas , Lawrence , Kansas , USA
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Hickey G, McGilloway S, Furlong M, Leckey Y, Bywater T, Donnelly M. Understanding the implementation and effectiveness of a group-based early parenting intervention: a process evaluation protocol. BMC Health Serv Res 2016; 16:490. [PMID: 27633777 PMCID: PMC5025622 DOI: 10.1186/s12913-016-1737-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2016] [Accepted: 09/01/2016] [Indexed: 12/04/2022] Open
Abstract
Background Group-based early parenting interventions delivered through community-based services may be a potentially effective means of promoting infant and family health and wellbeing. Process evaluations of these complex interventions provide vital information on how they work, as well as the conditions which shape and influence outcomes. This information is critical to decision makers and service providers who wish to embed prevention and early interventions in usual care settings. In this paper, a process evaluation protocol for an early years parenting intervention, the Parent and Infant (PIN) program, is described. This program combines a range of developmentally-appropriate supports, delivered in a single intervention process, for parents and infants (0–2 years) and aimed at enhancing parental competence, strengthening parent-infant relationships and improving infant wellbeing and adjustment. Methods The process evaluation is embedded within a controlled trial and accompanying cost-effectiveness evaluation. Building from extant frameworks and evaluation methods, this paper presents a systematic approach to the process evaluation of the PIN program and its underlying change principles, the implementation of the program, the context of implementation and the change mechanisms which influence and shape parent and infant outcomes. We will use a multi-method strategy, including semi-structured interviews and group discussions with key stakeholders, documentary analysis and survey methodology. Discussion The integration of innovations into existing early years systems and services is a challenging multifaceted undertaking. This process evaluation will make an important contribution to knowledge about the implementation of such programs, while also providing an example of how theory-based research can be embedded within the evaluation of community-based interventions. We discuss the strengths of the research, such as the adoption of a collaborative approach to data collection, while we also identify potential challenges, including capturing and assessing complex aspects of the intervention. Trial registration ISRCTN17488830 (Date of registration: 27/11/15). This trial was retrospectively registered. Electronic supplementary material The online version of this article (doi:10.1186/s12913-016-1737-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Grainne Hickey
- Mental Health and Social Research Unit, Maynooth University Department of Psychology, John Hume Building, National University of Ireland Maynooth, Maynooth, Co. Kildare, Ireland
| | - Sinead McGilloway
- Mental Health and Social Research Unit, Maynooth University Department of Psychology, John Hume Building, National University of Ireland Maynooth, Maynooth, Co. Kildare, Ireland.
| | - Mairead Furlong
- Mental Health and Social Research Unit, Maynooth University Department of Psychology, John Hume Building, National University of Ireland Maynooth, Maynooth, Co. Kildare, Ireland
| | - Yvonne Leckey
- Mental Health and Social Research Unit, Maynooth University Department of Psychology, John Hume Building, National University of Ireland Maynooth, Maynooth, Co. Kildare, Ireland
| | - Tracey Bywater
- Department of Health Sciences, Faculty of Sciences, Seebohm Rowntree Building, University of York, York, UK
| | - Michael Donnelly
- UKCRC Centre of Excellence for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, Northern Ireland
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Wang D, Ogihara M, Gallo C, Villamar JA, Smith JD, Vermeer W, Cruden G, Benbow N, Brown CH. Automatic classification of communication logs into implementation stages via text analysis. Implement Sci 2016; 11:119. [PMID: 27600612 PMCID: PMC5011842 DOI: 10.1186/s13012-016-0483-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2015] [Accepted: 07/28/2016] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND To improve the quality, quantity, and speed of implementation, careful monitoring of the implementation process is required. However, some health organizations have such limited capacity to collect, organize, and synthesize information relevant to its decision to implement an evidence-based program, the preparation steps necessary for successful program adoption, the fidelity of program delivery, and the sustainment of this program over time. When a large health system implements an evidence-based program across multiple sites, a trained intermediary or broker may provide such monitoring and feedback, but this task is labor intensive and not easily scaled up for large numbers of sites. We present a novel approach to producing an automated system of monitoring implementation stage entrances and exits based on a computational analysis of communication log notes generated by implementation brokers. Potentially discriminating keywords are identified using the definitions of the stages and experts' coding of a portion of the log notes. A machine learning algorithm produces a decision rule to classify remaining, unclassified log notes. RESULTS We applied this procedure to log notes in the implementation trial of multidimensional treatment foster care in the California 40-county implementation trial (CAL-40) project, using the stages of implementation completion (SIC) measure. We found that a semi-supervised non-negative matrix factorization method accurately identified most stage transitions. Another computational model was built for determining the start and the end of each stage. CONCLUSIONS This automated system demonstrated feasibility in this proof of concept challenge. We provide suggestions on how such a system can be used to improve the speed, quality, quantity, and sustainment of implementation. The innovative methods presented here are not intended to replace the expertise and judgement of an expert rater already in place. Rather, these can be used when human monitoring and feedback is too expensive to use or maintain. These methods rely on digitized text that already exists or can be collected with minimal to no intrusiveness and can signal when additional attention or remediation is required during implementation. Thus, resources can be allocated according to need rather than universally applied, or worse, not applied at all due to their cost.
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Affiliation(s)
- Dingding Wang
- Department of Computer Science, Florida Atlantic University, 777 Glades Road EE 403, Boca Raton, FL, USA
| | - Mitsunori Ogihara
- Department of Computer Science and Center for Computational Science, University of Miami, 1320 S. Dixie Highway, Miami, FL, USA
| | - Carlos Gallo
- Center for Prevention Implementation Methodology, Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine Northwestern University, 750 N. Lake Shore Dr., Chicago, IL, USA
| | - Juan A Villamar
- Center for Prevention Implementation Methodology, Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine Northwestern University, 750 N. Lake Shore Dr., Chicago, IL, USA
| | - Justin D Smith
- Center for Prevention Implementation Methodology, Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine Northwestern University, 750 N. Lake Shore Dr., Chicago, IL, USA
| | - Wouter Vermeer
- Center for Prevention Implementation Methodology, Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine Northwestern University, 750 N. Lake Shore Dr., Chicago, IL, USA
| | - Gracelyn Cruden
- Department of Health Policy and Management, University of North Carolina, Chapel Hill, 135 Dauer Drive, Chapel Hill, NC, USA
| | - Nanette Benbow
- Center for Prevention Implementation Methodology, Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine Northwestern University, 750 N. Lake Shore Dr., Chicago, IL, USA
| | - C Hendricks Brown
- Center for Prevention Implementation Methodology, Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine Northwestern University, 750 N. Lake Shore Dr., Chicago, IL, USA.
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Akin BA, Brook J, Lloyd MH, Bhattarai J, Johnson-Motoyama M, Moses M. A study in contrasts: Supports and barriers to successful implementation of two evidence-based parenting interventions in child welfare. CHILD ABUSE & NEGLECT 2016; 57:30-40. [PMID: 27288761 DOI: 10.1016/j.chiabu.2016.06.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2016] [Revised: 05/28/2016] [Accepted: 06/01/2016] [Indexed: 06/06/2023]
Abstract
Although evidence-based interventions (EBIs) are spreading to child welfare, research on real-world dynamics of implementation within this setting is scarce. Using a six-factor implementation framework to examine implementation of two evidence-based parenting interventions, we sought to build greater understanding of key facilitators and barriers by comparing successful versus failed EBI implementation in a child welfare setting. Semi-structured interviews were conducted with a purposive sample of 15 frontline practitioners and state-level managers. Interviews were transcribed verbatim and data analysis used a modified analytic approach. Our results showed the successful EBI was viewed more positively on all six factors; however, implementation was multidimensional, multilevel, and mixed with accomplishments and challenges. An accumulation of strengths across implementation factors proved beneficial. Implementation frameworks may be advantageous in organizing and explaining the numerous factors that may influence successful versus failed implementation. While encountering obstacles is largely inevitable, understanding which factors have shaped the success or failure of EBI implementations in child welfare settings may optimize future implementations in this context.
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Affiliation(s)
- Becci A Akin
- University of Kansas, School of Social Welfare, United States.
| | - Jody Brook
- University of Kansas, School of Social Welfare, United States
| | | | | | | | - Mindi Moses
- University of Kansas, School of Social Welfare, United States
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Ehrhart MG, Torres EM, Wright LA, Martinez SY, Aarons GA. Validating the Implementation Climate Scale (ICS) in child welfare organizations. CHILD ABUSE & NEGLECT 2016; 53:17-26. [PMID: 26563643 PMCID: PMC4818155 DOI: 10.1016/j.chiabu.2015.10.017] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2015] [Revised: 10/02/2015] [Accepted: 10/19/2015] [Indexed: 06/05/2023]
Abstract
There is increasing emphasis on the use of evidence-based practices (EBPs) in child welfare settings and growing recognition of the importance of the organizational environment, and the organization's climate in particular, for how employees perceive and support EBP implementation. Recently, Ehrhart, Aarons, and Farahnak (2014) reported on the development and validation of a measure of EBP implementation climate, the Implementation Climate Scale (ICS), in a sample of mental health clinicians. The ICS consists of 18 items and measures six critical dimensions of implementation climate: focus on EBP, educational support for EBP, recognition for EBP, rewards for EBP, selection or EBP, and selection for openness. The goal of the current study is to extend this work by providing evidence for the factor structure, reliability, and validity of the ICS in a sample of child welfare service providers. Survey data were collected from 215 child welfare providers across three states, 12 organizations, and 43 teams. Confirmatory factor analysis demonstrated good fit to the six-factor model and the alpha reliabilities for the overall measure and its subscales was acceptable. In addition, there was general support for the invariance of the factor structure across the child welfare and mental health sectors. In conclusion, this study provides evidence for the factor structure, reliability, and validity of the ICS measure for use in child welfare service organizations.
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Affiliation(s)
- Mark G. Ehrhart
- Department of Psychology, San Diego State University, San Diego, CA USA
| | - Elisa M. Torres
- Department of Psychiatry, University of California, San Diego, La Jolla, CA USA
- Child and Adolescent Services Research Center, San Diego, CA USA
| | - Lisa A. Wright
- Department of Psychology, San Diego State University, San Diego, CA USA
| | | | - Gregory A. Aarons
- Department of Psychiatry, University of California, San Diego, La Jolla, CA USA
- Child and Adolescent Services Research Center, San Diego, CA USA
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Oxford ML, Marcenko M, Fleming CB, Lohr MJ, Spieker SJ. Promoting Birth Parents' Relationships with their Toddlers upon Reunification: Results from Promoting First Relationships ® Home Visiting Program. CHILDREN AND YOUTH SERVICES REVIEW 2016; 61:109-116. [PMID: 26869740 PMCID: PMC4746016 DOI: 10.1016/j.childyouth.2015.12.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Birth parents, once reunified with their child after a foster care placement, are in need of in-home support services to prevent reoccurrence of maltreatment and reentry into foster care, establish a strong relationship with their child, and enhance child well-being. Few studies have addressed the efficacy of home visiting services for reunified birth parents of toddlers. This study reports on the findings from a randomized control trial of a 10-week home visiting program, Promoting First Relationships® (Kelly, Sandoval, Zuckerman, & Buehlman, 2008), for a subsample of 43 reunified birth parents that were part of the larger trial. We describe how the elements of the intervention align with the needs of parents and children in child welfare. Although the sample size was small and most of the estimates of intervention effects were not statistically significant, the effect sizes and the pattern of results suggest that the intervention may have improved both observed parenting sensitivity and observed child behaviors as well as decreased parent report of child behavior problems. Implications are that providing in-home services soon after a reunification may be efficacious in strengthening birth parents' capacity to respond sensitively to their children as well as improving child social and emotional outcomes and well-being.
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Schneiderman JU, Smith C, Arnold-Clark JS, Fuentes J, Kennedy AK. Pediatric Return Appointment Adherence for Child Welfare-Involved Children in Los Angeles California. Matern Child Health J 2016; 20:477-83. [PMID: 26520153 PMCID: PMC4740213 DOI: 10.1007/s10995-015-1845-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVES This study of primarily Latino caregivers and Latino child welfare-involved children had the following aims: (1) explore the return appointment adherence patterns at a pediatric medical clinic; and (2) determine the relationship of adherence to return appointments and caregiver, child, and clinic variables. METHODS The sample consisted of caregivers of child welfare-involved children who were asked to make a pediatric outpatient clinic return appointment (N = 87). Predictors included caregiver demographics, child medical diagnoses and age, and clinic/convenience factors including distance from the clinic to caregiver's home, days until the return appointment, reminder telephone call, Latino provider, and additional specialty appointment. Predictors were examined using χ(2) and t tests of significance. RESULTS Thirty-nine percent of all caregivers were nonadherent in returning for pediatric appointments. When return appointments were scheduled longer after the initial appointment, caregivers were less likely to bring children back for medical care. CONCLUSIONS The 39 % missed return appointment rate in this study is higher than other similar pediatric populations. Better coordination between pediatricians and caregivers in partnership with child welfare case workers is needed to ensure consistent follow-up regarding health problems, especially when appointments are not scheduled soon after the initial appointment.
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Affiliation(s)
- Janet U Schneiderman
- School of Social Work, University of Southern California, 669 West 34th Street, Los Angeles, CA, 90089-0411, USA.
| | - Caitlin Smith
- Department of Psychology, University of Southern California, Los Angeles, CA, USA.
| | - Janet S Arnold-Clark
- Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
| | - Jorge Fuentes
- Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
| | - Andrea K Kennedy
- School of Social Work, University of Southern California, 669 West 34th Street, Los Angeles, CA, 90089-0411, USA.
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Walker SC, Bishop AS, Pullmann MD, Bauer G. A Research Framework for Understanding the Practical Impact of Family Involvement in the Juvenile Justice System: The Juvenile Justice Family Involvement Model. AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY 2015; 56:408-21. [PMID: 26407854 DOI: 10.1007/s10464-015-9755-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
Family involvement is recognized as a critical element of service planning for children's mental health, welfare and education. For the juvenile justice system, however, parents' roles in this system are complex due to youths' legal rights, public safety, a process which can legally position parents as plaintiffs, and a historical legacy of blaming parents for youth indiscretions. Three recent national surveys of juvenile justice-involved parents reveal that the current paradigm elicits feelings of stress, shame and distrust among parents and is likely leading to worse outcomes for youth, families and communities. While research on the impact of family involvement in the justice system is starting to emerge, the field currently has no organizing framework to guide a research agenda, interpret outcomes or translate findings for practitioners. We propose a research framework for family involvement that is informed by a comprehensive review and content analysis of current, published arguments for family involvement in juvenile justice along with a synthesis of family involvement efforts in other child-serving systems. In this model, family involvement is presented as an ascending, ordinal concept beginning with (1) exclusion, and moving toward climates characterized by (2) information-giving, (3) information-eliciting and (4) full, decision-making partnerships. Specific examples of how courts and facilities might align with these levels are described. Further, the model makes predictions for how involvement will impact outcomes at multiple levels with applications for other child-serving systems.
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Affiliation(s)
- Sarah Cusworth Walker
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, 2815 Eastlake Ave E Ste 200, Seattle, WA, 98102, USA.
| | - Asia S Bishop
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, 2815 Eastlake Ave E Ste 200, Seattle, WA, 98102, USA.
| | - Michael D Pullmann
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, 2815 Eastlake Ave E Ste 200, Seattle, WA, 98102, USA.
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Wisdom JP, Chor KHB, Hoagwood KE, Horwitz SM. Innovation adoption: a review of theories and constructs. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2015; 41:480-502. [PMID: 23549911 DOI: 10.1007/s10488-013-0486-4] [Citation(s) in RCA: 127] [Impact Index Per Article: 14.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Many theoretical frameworks seek to describe the dynamic process of the implementation of innovations. Little is known, however, about factors related to decisions to adopt innovations and how the likelihood of adoption of innovations can be increased. Using a narrative synthesis approach, this paper compared constructs theorized to be related to adoption of innovations proposed in existing theoretical frameworks in order to identify characteristics likely to increase adoption of innovations. The overall goal was to identify elements across adoption frameworks that are potentially modifiable and, thus, might be employed to improve the adoption of evidence-based practices. The review identified 20 theoretical frameworks that could be grouped into two broad categories: theories that mainly address the adoption process (N = 10) and theories that address adoption within the context of implementation, diffusion, dissemination, and/or sustainability (N = 10). Constructs of leadership, operational size and structure, innovation fit with norms and values, and attitudes/motivation toward innovations each are mentioned in at least half of the theories, though there were no consistent definitions of measures for these constructs. A lack of precise definitions and measurement of constructs suggests further work is needed to increase our understanding of adoption of innovations.
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Affiliation(s)
- Jennifer P Wisdom
- George Washington University, 2121 Eye Street Suite 601, Washington, DC, 20052, USA,
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Ek A, Chamberlain KL, Ejderhamn J, Fisher PA, Marcus C, Chamberlain P, Nowicka P. The More and Less Study: a randomized controlled trial testing different approaches to treat obesity in preschoolers. BMC Public Health 2015; 15:735. [PMID: 26231850 PMCID: PMC4522072 DOI: 10.1186/s12889-015-1912-1] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2015] [Accepted: 06/08/2015] [Indexed: 01/13/2023] Open
Abstract
Background While obesity has been shown to be difficult to treat in school aged children and in adolescence, promising results have been detected for children who started treatment in early childhood. Yet knowledge on the effectiveness of structured early childhood obesity treatment programs is limited, preventing the widespread implementation of such programs. The main objective of this study is to evaluate the effectiveness of early treatment of childhood obesity with respect to treatment focus (parenting practices or lifestyle), length and intensity. The study will also examine the influence of gender, age, parental weight status, parenting practices, child behavior as well as parents’ socioeconomic status and child and parental psychosocial health on children’s weight status. Methods/design This is a parallel open label randomized controlled trial assessing two different behavioral treatment approaches offered in three conditions to families with children aged 4–6 years in Stockholm County, Sweden. Children (n = 180) identified as obese will be referred from primary child health care, school health care, and from outpatient pediatric clinics, and randomized to: 1) a standard treatment with focus on lifestyle, provided within the current healthcare system (n = 90); 2) a 10-session, 1.5 h/week group treatment with focus on parenting (n = 45); or 3) the same group treatment as 2) with additional follow-up sessions (n = 45). The primary study outcome is change in children’s body mass index standard deviation score (BMI SDS) one year post-baseline. Secondary outcomes include changes in children’s waist circumference, metabolic health, lifestyle patterns (Food Frequency Questionnaire), obesity-related child behaviors (Child Eating Behavior Questionnaire and Lifestyle Behavior Checklist, Problem Scale), parents’ general and feeding parenting practices (Communicating with Children and Child Feeding Questionnaire) and lifestyle-specific self-efficacy (Lifestyle Behavior Checklist, Confidence Scale), family functioning (Family Assessment Device), child and parental psychosocial health (Child Behavior Checklist and Beck’s Depression Inventory II). Discussion This study will facilitate a close examination of key components of treatment for obesity during early childhood and mechanisms of change. Results from this study will lead to better healthcare options for obesity treatment during early childhood and ultimately to the prevention of obesity later in life. Trial registration ClinicalTrials.gov NCT01792531 Registered February 14, 2013.
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Affiliation(s)
- Anna Ek
- Division of Pediatrics, B62, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, 141 86, Stockholm, Sweden.
| | | | - Jan Ejderhamn
- Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden.
| | - Philip A Fisher
- Oregon Social Learning Center, Eugene, OR, USA. philf@uoregon.\edu.,University of Oregon, Eugene, OR, USA. philf@uoregon.\edu
| | - Claude Marcus
- Division of Pediatrics, B62, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, 141 86, Stockholm, Sweden.
| | | | - Paulina Nowicka
- Division of Pediatrics, B62, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, 141 86, Stockholm, Sweden.
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Paschall KW, Gonzalez H, Mortensen JA, Barnett MA, Mastergeorge AM. Children's negative emotionality moderates influence of parenting styles on preschool classroom adjustment. JOURNAL OF APPLIED DEVELOPMENTAL PSYCHOLOGY 2015. [DOI: 10.1016/j.appdev.2015.04.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Cook JM, Dinnen S, Coyne JC, Thompson R, Simiola V, Ruzek J, Schnurr PP. Evaluation of an implementation model: a national investigation of VA residential programs. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2015; 42:147-56. [PMID: 24817625 PMCID: PMC4240747 DOI: 10.1007/s10488-014-0555-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
This national investigation utilizes qualitative data to evaluate an implementation model regarding factors influencing provider use of two evidence-based treatments for posttraumatic stress disorder (PTSD). Semi-structured qualitative interviews with 198 mental health providers from 38 Department of Veterans Affairs' (VA) residential treatment programs were used to explore these issues regarding prolonged exposure (PE) and cognitive processing therapy (CPT) in VA residential PTSD programs. Several unique and some overlapping predictors emerged. Leadership was viewed as an influence on implementation for both CPT and PE, while a lack of dedicated time and resources was viewed as a deterrent for both. Compatibility of CPT with providers' existing practices and beliefs, the ability to observe noticeable patient improvement, a perceived relative advantage of CPT over alternative treatments, and the presence of a supportive peer network emerged as influential on CPT implementation. Leadership was associated with PE implementation. Implications for the design and improvement of training and implementation efforts are discussed.
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Affiliation(s)
- Joan M Cook
- Yale School of Medicine and National Center for PTSD, 950 Campbell Avenue, NEPEC/182, West Haven, CT, 06516, USA,
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Topitzes J, Mersky JP, McNeil CB. Implementation of Parent Child Interaction Therapy Within Foster Care: An Attempt to Translate an Evidence-Based Program Within a Local Child Welfare Agency. JOURNAL OF PUBLIC CHILD WELFARE 2015; 9:22-41. [PMID: 25729340 PMCID: PMC4342056 DOI: 10.1080/15548732.2014.983288] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2013] [Accepted: 10/29/2014] [Indexed: 06/04/2023]
Abstract
This paper describes an innovative adaptation of an evidence-based intervention - Parent Child Interaction Therapy or PCIT - to foster parent training services. The authors faced multiple problems that commonly plague translational child welfare research as they developed, implemented and tested their model. The paper discusses how the authors addressed these problems when: 1) specifying the child welfare context in which the intervention model was implemented and tested, choosing an intervention model that responded to child welfare service needs, and tailoring the model for a child welfare context; 2) securing external funding and initiating sustainability plans for model uptake; and 3) forging a university-community partnership to overcome logistical and ethical obstacles. Concluding with a summary of promising preliminary study results, a description of future plans to replicate and spread the model, and a distillation of project lessons, the paper suggests that child welfare translational research with PCIT is very promising.
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Affiliation(s)
- James Topitzes
- University of Wisconsin-Milwaukee, Helen Bader School of Social Welfare
| | - Joshua P. Mersky
- University of Illinois-Chicago, Jane Addams College of Social Work
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Kothari BH, McBeath B, Lamson-Siu E, Webb SJ, Sorenson P, Bowen H, Waid J, Bank L. Development and feasibility of a sibling intervention for youth in foster care. EVALUATION AND PROGRAM PLANNING 2014; 47:91-9. [PMID: 25194833 PMCID: PMC7271973 DOI: 10.1016/j.evalprogplan.2014.08.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2014] [Revised: 06/30/2014] [Accepted: 08/17/2014] [Indexed: 05/11/2023]
Abstract
Due to their ubiquity and possible influence on youth mental health, academic, and other outcomes, sibling-focused intervention strategies may be important for the development and implementation of evidence-based practices (EBPs) in child welfare. However, there is no rigorous evidence as to either the best methods for, or feasibility of, incorporating the sibling link within existing clinical treatments for foster youth. This paper applies the literature on evidence-based practices (EBP) and implementation research in child welfare to sibling-focused intervention; and presents data concerning the development, delivery, cost, and feasibility of a novel sibling-focused intervention program, Supporting Siblings in Foster Care (SIBS-FC). Results suggest that despite the challenges and costs involved with delivering SIBS-FC, the program catered to the diverse needs of pre-adolescent and adolescent siblings living together and apart, was viewed positively by youth, and was implemented with a high degree of fidelity. These findings underscore the importance of attending to the early-stage development of psychosocial interventions in child welfare and highlight the role of interagency collaboration, program planning, staff training and supervision, and fidelity tracking for EBP development in child welfare. Implications for prevention research and sibling-focused intervention programming in child welfare are discussed.
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Affiliation(s)
- Brianne H Kothari
- Oregon State University-Cascades, 2600 NW College Way, Bend, OR 97701, United States.
| | - Bowen McBeath
- Portland State University, School of Social Work, 1600 SW 4th Ave., Ste. 400, Portland, OR 97201, United States; Oregon Social Learning Center, 10 Shelton McMurphey Blvd., Eugene, OR 97401, United States
| | - Emilie Lamson-Siu
- Portland State University, School of Social Work, 1600 SW 4th Ave., Ste. 400, Portland, OR 97201, United States
| | - Sara Jade Webb
- Portland State University, School of Social Work, 1600 SW 4th Ave., Ste. 400, Portland, OR 97201, United States
| | - Paul Sorenson
- Portland State University, School of Social Work, 1600 SW 4th Ave., Ste. 400, Portland, OR 97201, United States
| | - Hannah Bowen
- Portland State University, School of Social Work, 1600 SW 4th Ave., Ste. 400, Portland, OR 97201, United States
| | - Jeff Waid
- Portland State University, School of Social Work, 1600 SW 4th Ave., Ste. 400, Portland, OR 97201, United States
| | - Lew Bank
- Portland State University, School of Social Work, 1600 SW 4th Ave., Ste. 400, Portland, OR 97201, United States; Oregon Social Learning Center, 10 Shelton McMurphey Blvd., Eugene, OR 97401, United States
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Stone S, Zibulsky J. MALTREATMENT, ACADEMIC DIFFICULTY, AND SYSTEMS-INVOLVED YOUTH: CURRENT EVIDENCE AND OPPORTUNITIES. PSYCHOLOGY IN THE SCHOOLS 2014. [DOI: 10.1002/pits.21812] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Horwitz SM, Hurlburt MS, Goldhaber-Fiebert JD, Palinkas LA, Rolls-Reutz J, Zhang J, Fisher E, Landsverk J. Exploration and Adoption of Evidence-based Practice by US Child Welfare Agencies. CHILDREN AND YOUTH SERVICES REVIEW 2014; 39:147-152. [PMID: 24659841 PMCID: PMC3960081 DOI: 10.1016/j.childyouth.2013.10.004] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
OBJECTIVE To examine the extent to which child welfare agencies adopt new practices and to determine the barriers to and facilitators of adoption of new practices. METHODS Data came from telephone interviews with the directors of the 92 public child welfare agencies that constituted the probability sample for the first National Survey of Child and Adolescent Well-being (NSCAWI). In a semi-structured 40 minute interview administered by a trained Research Associate, agency directors were asked about agency demographics, knowledge of evidence-based practices, use of technical assistance and actual use of evidence-based practices.. Of the 92 agencies, 83 or 90% agreed to be interviewed. RESULTS Agencies reported that the majority of staff had a BA degree (53.45%) and that they either paid for (52.6%) or provided (80.7%) continuing education. Although agencies routinely collect standardized child outcomes (90%) they much less frequently collect measures of child functioning (30.9%). Almost all agencies (94%) had started a new program or practice but only 24.8% were evidence-based and strategies used to explore new programs or practices usually involved local or state contracts. Factors that were associated with program success included internal support for the innovation (27.3%), and an existing evidence base (23.5%). CONCLUSIONS Directors of child welfare agencies frequently institute new programs or practices but they are not often evidence-based. Because virtually all agencies provide some continuing education adding discussions of evidence-based programs/practices may spur adaption. Reliance on local and state colleagues to explore new programs and practices suggests that developing well informed social networks may be a way to increase the spread of evidence0based practices.
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Affiliation(s)
- Sarah McCue Horwitz
- Department of Pediatrics and Stanford Health Policy, 117 Encina Commons, Stanford, CA, USA 94305,
| | - Michael S Hurlburt
- School of Social Work, University of Southern California, Los Angeles, CA, USA, 90089,
| | | | - Lawrence A Palinkas
- School of Social Work, MRF339, University of Southern California, Los Angeles, CA, USA, 90089,
| | - Jennifer Rolls-Reutz
- Child and Adolescent Services Research Center, Rady Children's Hospital, San Diego, 3022 Children's Way, MC 5033, San Diego, CA, USA, 92123,
| | - Jinjin Zhang
- Child and Adolescent Services Research Center, Rady Children's Hospital, San Diego, 3022 Children's Way, MC 5033, San Diego, CA, USA, 92123,
| | - Emily Fisher
- Child and Adolescent Services Research Center, Rady Children's Hospital, San Diego, 3022 Children's Way, MC 5033, San Diego, CA, USA, 92123,
| | - John Landsverk
- Child and Adolescent Services Research Center, Rady Children's Hospital, San Diego, 3022 Children's Way, MC 5033, San Diego, CA, USA, 92123,
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Romney S, Israel N, Zlatevski D. Exploration-Stage Implementation Variation. ZEITSCHRIFT FUR PSYCHOLOGIE-JOURNAL OF PSYCHOLOGY 2014. [DOI: 10.1027/2151-2604/a000164] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The present study examines the effect of agency-level implementation variation on the cost-effectiveness of an evidence-based parent training program (Positive Parenting Program: “Triple P”). Staff from six community-based agencies participated in a five-day training to prepare them to deliver a 12-week Triple P parent training group to caregivers. Prior to the training, administrators and staff from four of the agencies completed a site readiness process intended to prepare them for the implementation demands of successfully delivering the group, while the other two agencies did not complete the process. Following the delivery of each agency’s first Triple P group, the graduation rate and average cost per class graduate were calculated. The average cost-per-graduate was over seven times higher for the two agencies that had not completed the readiness process than for the four completing agencies ($7,811 vs. $1,052). The contrast in costs was due to high participant attrition in the Triple P groups delivered by the two agencies that did not complete the readiness process. The odds of Triple P participants graduating were 12.2 times greater for those in groups run by sites that had completed the readiness process. This differential attrition was not accounted for by between-group differences in participant characteristics at pretest. While the natural design of this study limits the ability to empirically test all alternative explanations, these findings indicate a striking cost savings for sites completing the readiness process and support the thoughtful application of readiness procedures in the early stages of an implementation initiative.
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Affiliation(s)
- Stephanie Romney
- The Parent Training Institute, San Francisco Department of Public Health, San Francisco, CA, USA
| | - Nathaniel Israel
- The Parent Training Institute, San Francisco Department of Public Health, San Francisco, CA, USA
| | - Danijela Zlatevski
- The Parent Training Institute, San Francisco Department of Public Health, San Francisco, CA, USA
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Bryson SA, Akin BA, Blase KA, McDonald T, Walker S. Selecting an EBP to reduce long-term foster care: lessons from a university-child welfare agency partnership. JOURNAL OF EVIDENCE-BASED SOCIAL WORK 2014; 11:208-221. [PMID: 24405144 DOI: 10.1080/15433714.2013.850325] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
A growing implementation literature outlines broad evidence-based practice implementation principles and pitfalls. Less robust is knowledge about the real-world process by which a state or agency chooses an evidence-based practice to implement and evaluate. Using a major U.S. initiative to reduce long-term foster care as the case, this article describes three major aspects of the evidence-based practice selection process: defining a target population, selecting an evidence-based practice model and purveyor, and tailoring the model to the practice context. Use of implementation science guidelines and lessons learned from a unique private-public-university partnership are discussed.
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Affiliation(s)
- Stephanie A Bryson
- a School of Social Welfare, University of Kansas , Lawrence , Kansas , USA
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Brown CH, Mohr DC, Gallo CG, Mader C, Palinkas L, Wingood G, Prado G, Kellam SG, Pantin H, Poduska J, Gibbons R, McManus J, Ogihara M, Valente T, Wulczyn F, Czaja S, Sutcliffe G, Villamar J, Jacobs C. A computational future for preventing HIV in minority communities: how advanced technology can improve implementation of effective programs. J Acquir Immune Defic Syndr 2013; 63 Suppl 1:S72-84. [PMID: 23673892 PMCID: PMC3746769 DOI: 10.1097/qai.0b013e31829372bd] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
African Americans and Hispanics in the United States have much higher rates of HIV than non-minorities. There is now strong evidence that a range of behavioral interventions are efficacious in reducing sexual risk behavior in these populations. Although a handful of these programs are just beginning to be disseminated widely, we still have not implemented effective programs to a level that would reduce the population incidence of HIV for minorities. We proposed that innovative approaches involving computational technologies be explored for their use in both developing new interventions and in supporting wide-scale implementation of effective behavioral interventions. Mobile technologies have a place in both of these activities. First, mobile technologies can be used in sensing contexts and interacting to the unique preferences and needs of individuals at times where intervention to reduce risk would be most impactful. Second, mobile technologies can be used to improve the delivery of interventions by facilitators and their agencies. Systems science methods including social network analysis, agent-based models, computational linguistics, intelligent data analysis, and systems and software engineering all have strategic roles that can bring about advances in HIV prevention in minority communities. Using an existing mobile technology for depression and 3 effective HIV prevention programs, we illustrated how 8 areas in the intervention/implementation process can use innovative computational approaches to advance intervention adoption, fidelity, and sustainability.
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Affiliation(s)
- C Hendricks Brown
- Department of Public Health Sciences, Miller School of Medicine, University of Miami, Coral Gables, FL 33136, USA.
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Wisdom JP, Chor KHB, Hoagwood KE, Horwitz SM. Innovation adoption: a review of theories and constructs. ADMINISTRATION AND POLICY IN MENTAL HEALTH 2013. [PMID: 23549911 DOI: 10.1007/s10488‐013‐0486‐4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Many theoretical frameworks seek to describe the dynamic process of the implementation of innovations. Little is known, however, about factors related to decisions to adopt innovations and how the likelihood of adoption of innovations can be increased. Using a narrative synthesis approach, this paper compared constructs theorized to be related to adoption of innovations proposed in existing theoretical frameworks in order to identify characteristics likely to increase adoption of innovations. The overall goal was to identify elements across adoption frameworks that are potentially modifiable and, thus, might be employed to improve the adoption of evidence-based practices. The review identified 20 theoretical frameworks that could be grouped into two broad categories: theories that mainly address the adoption process (N = 10) and theories that address adoption within the context of implementation, diffusion, dissemination, and/or sustainability (N = 10). Constructs of leadership, operational size and structure, innovation fit with norms and values, and attitudes/motivation toward innovations each are mentioned in at least half of the theories, though there were no consistent definitions of measures for these constructs. A lack of precise definitions and measurement of constructs suggests further work is needed to increase our understanding of adoption of innovations.
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Affiliation(s)
- Jennifer P Wisdom
- George Washington University, 2121 Eye Street Suite 601, Washington, DC, 20052, USA,
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Leve LD, Harold GT, Chamberlain P, Landsverk JA, Fisher PA, Vostanis P. Practitioner review: Children in foster care--vulnerabilities and evidence-based interventions that promote resilience processes. J Child Psychol Psychiatry 2012; 53:1197-211. [PMID: 22882015 PMCID: PMC3505234 DOI: 10.1111/j.1469-7610.2012.02594.x] [Citation(s) in RCA: 134] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND An increasing number of children are placed in foster care (i.e., a kin or nonkin family home other than the biological parent) due to experiences of physical, sexual, emotional, or psychological abuse, and/or neglect. Children in foster care are at increased risk for a host of negative outcomes encompassing emotional, behavioral, neurobiological, and social realms. METHODS Areas of risk and vulnerability among foster children are described, including emotional and behavioral deficits, impaired neurobiological development, and social relationship deficits. Evidence suggesting the significance of family placement changes and prenatal exposure to substances as contributing mechanisms is presented. Based on a systematic search of the PsycINFO database (to March 2012), eight efficacious evidence-based interventions for foster families are summarized. FINDINGS Although the development of evidence-based interventions that improve outcomes for foster children has lagged behind the delivery of interventions in other service sectors (e.g., mental health and educational sectors), several interventions across childhood and adolescence offer promise. Service system constraints offer both challenges and opportunities for more routine implementation of evidence-based interventions. CONCLUSIONS Given the increased likelihood of poor outcomes for foster children, increased efforts to understand the pathways to vulnerability and to implement interventions shown to be effective in remediating risks and improving outcomes for this population are indicated. Evaluation of efficacious interventions in countries outside of the United States is also needed.
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Affiliation(s)
- Leslie D Leve
- Oregon Social Learning Center, Eugene, OR 97401, USA.
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Goldhaber-Fiebert JD, Bailey SL, Hurlburt MS, Zhang J, Snowden LR, Wulczyn F, Landsverk J, Horwitz SM. Evaluating child welfare policies with decision-analytic simulation models. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2012; 39:466-77. [PMID: 21861204 PMCID: PMC3589566 DOI: 10.1007/s10488-011-0370-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
The objective was to demonstrate decision-analytic modeling in support of Child Welfare policymakers considering implementing evidence-based interventions. Outcomes included permanency (e.g., adoptions) and stability (e.g., foster placement changes). Analyses of a randomized trial of KEEP-a foster parenting intervention-and NSCAW-1 estimated placement change rates and KEEP's effects. A microsimulation model generalized these findings to other Child Welfare systems. The model projected that KEEP could increase permanency and stability, identifying strategies targeting higher-risk children and geographical regions that achieve benefits efficiently. Decision-analytic models enable planners to gauge the value of potential implementations.
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Azar S, Robinson L, Proctor S. Chronic Neglect and Services Without Borders: A Guiding Model for Social Service Enhancement to Address the Needs of Parents With Intellectual Disabilities. JOURNAL OF MENTAL HEALTH RESEARCH IN INTELLECTUAL DISABILITIES 2012; 5:130-156. [PMID: 27617050 PMCID: PMC5013828 DOI: 10.1080/19315864.2011.592238] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
Child neglect has negative effects throughout the lifespan. Although an argument for a link between intellectual disabilities and neglectful parenting can be made, this paper argues for a more fine grained view of the cognitive problems that underlie child neglect perpetration and provides evidence for a social information processing model of etiology. Based on this model and what is known about the efficacy of behaviorally-based interventions, implications for enhancements to the social service system to adapt to the needs of parents with intellectual disabilities are presented. The areas covered include improvements to screening and assessment of parents; provision of adapted services; and changes in selection processes and training of staff. Future directions for integrating social information processing elements into interventions are discussed with examples from empirically tested prevention programs.
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Affiliation(s)
- Sandra Azar
- Department of Psychology, The Pennsylvania State University
| | - Lara Robinson
- Department of Psychology, The Pennsylvania State University
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Shapiro CJ, Prinz RJ, Sanders MR. Facilitators and barriers to implementation of an evidence-based parenting intervention to prevent child maltreatment: the Triple P-Positive Parenting Program. CHILD MALTREATMENT 2012; 17:86-95. [PMID: 22089827 DOI: 10.1177/1077559511424774] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
The prevention of child maltreatment via parenting interventions requires implementation on a broad scale, which is facilitated by drawing on a multidisciplinary array of service workers located in multiple settings. This underscores the importance of understanding factors that impact worker implementation of evidenced-based parenting and family support interventions. This study involved structured interviews with 174 service providers from several disciplines who had been trained previously in the delivery of the Triple P-Positive Parenting Program. These follow-up interviews, conducted an average of about 2 years after professional in-service training, provided the basis for examining predictors of sustained program use. Predictors examined included facilitators and barriers to program use, as well as organizational and provider-level characteristics such as attitudes toward evidence-based interventions. Highlighting the importance of a systems-contextual perspective on implementation, several provider and organization-level characteristics significantly predicted program use including provider self-confidence after training, fit of program with ongoing duties, availability of posttraining support, and perceived benefit of intervention for children and families. Implications for prevention and implementation science are discussed in view of the challenges inherent in the field of child maltreatment.
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Affiliation(s)
- Cheri J Shapiro
- Parenting and Family Research Center, University of South Carolina, Columbia, SC 29208, USA.
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50
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Spielfogel JE, Leathers SJ, Christian E, McMeel LS. Parent Management Training, Relationships with Agency Staff, and Child Mental Health: Urban Foster Parents' Perspectives. CHILDREN AND YOUTH SERVICES REVIEW 2011; 33:2366-2374. [PMID: 22125353 PMCID: PMC3224045 DOI: 10.1016/j.childyouth.2011.08.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
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