The impact of training interventions on organizational readiness to support innovations in juvenile justice offices

Conditions of successful treatment referral practices with justice-involved youth: Qualitative insights from probation and service provider staff involved in JJ-TRIALS

INTRODUCTION

Compared to the general U.S. adolescent population, young people involved in the juvenile justice system are at greater risk of experiencing substance use (SU) issues. There are critical opportunities across the juvenile justice continuum, at points of interface with community-based treatment services, to screen and assess for SU issues, identify unmet treatment needs, and refer those in need to treatment. The treatment referral process is, however, complex, and contingent on a seamless nexus between juvenile justice operations and the wider treatment provider landscape. Given the lack of successful SU referrals among justice-involved youth and the variable referral rates across jurisdictions, this study's aim is to provide a qualitative, explanatory understanding of the conditions that together contribute to successful referring practices.

METHODS

The study is based on an analysis of a qualitative dataset comprising focus group data with probation and community-based behavioral health treatment staff working in 31 sites in 6 different states as part of the clustered randomized trial of an organizational change intervention known as JJ-TRIALS (Juvenile Justice Translational Research on Interventions for Adolescents in the Legal System). The data contain respondents' narratives on the achievements, successes, and challenges with implementing the intervention. The data were analyzed through a combination of strategies to identify the conditions that both facilitate and impede referral processes between probation offices and community-based SU treatment providers.

RESULTS

Participants across sites discussed the positive impacts that the JJ-TRIALS intervention had on their improved ability to communicate, collaborate, and collect data. From the interviews, seven main conditions were observed to contribute to successful SU treatment referral practices: (1) communication (inter-organizational); (2) collaboration; (3) data-driven practices; (4) family engagement; (5) institutionalized policy and referral documentation; (6) efficient referral policies and procedures; and (7) suitable and accessible system of treatment providers.

CONCLUSION

Findings highlight the value of a holistic understanding of successful treatment referrals for justice-involved youth and help inform research and practice efforts to identify and measure the many dimensions of referral-making at the interface of juvenile probation and behavioral health services.

Trauma-informed attitudes in residential treatment settings: Staff, child and youth factors predicting adoption, maintenance and change over time

BACKGROUND

Little is known about the benefits of implementing trauma-informed care (TIC) training programs for child welfare workers serving in out-of-home treatment settings, or about how staff, child and youth characteristics affect adoption of favorable attitudes towards TIC.

OBJECTIVE

This study aimed to understand how attitudes towards TIC changed over time for child welfare workers receiving training and monthly supervision sessions.

PARTICIPANTS AND SETTING

Child welfare workers (n = 429) serving juveniles mandated to protection or offender units (ages = 3-20 years), across 11 child protection agencies in Quebec, Canada.

METHODS

Participants completed the ARTIC-35 at pre-training, 6 months post-training, and 1 year follow-up. Multilevel mixed effect regression models were fit to examine outcomes for all subscales.

RESULTS

Participants reported small improvements in attitudes towards TIC at post-training and 1 year follow-up for subscales related to problematic child/youth behavior (β = 0.23-0.32, p's < 0.001). Multilevel modeling revealed that age group (adolescent), unit gender (boys) and legal mandate (offender) predicted higher pre-training TIC ratings for staff in management versus frontline positions across three subscales related to problematic child/youth behavior (β = 0.77-0.93, p's < 0.05) and two subscales related to trauma work and support needs (β = 0.66/0.84, p's < 0.05).

CONCLUSIONS

Results extend previous research demonstrating an association between TIC training and improved attitudes towards TIC over time, and highlight specific contexts in which frontline staff may experience more difficulty applying TIC-based principles than colleagues in management positions.

Examining the critical factors of computer-assisted audit tools and techniques adoption in the post-COVID-19 period: internal auditors perspective

Purpose

In light of the repercussions of the COVID-19 pandemic, electronic auditing otherwise known as computer-assisted audit tools and techniques (CAATTs) has become inevitable to automate the auditing process worldwide. Accordingly, the purpose of this study is to examine the influence of technological, organizational and environmental (TOE) factors on public sector adoption of CAATTs in developing countries such as Jordan under the COVID-19 pandemic conditions.

Design/methodology/approach

This study used 136 usable responses from the managers of internal audit (IA) of the Jordanian public sector entities. The data collected were analyzed using partial least squares-structural equation modeling. The TOE framework has been used in this study to consider a wide set of TOE factors. Then, this study suggests a CAATTs adoption model that incorporates the related technology factors of the diffusion of innovation theory to environmental and organizational factors. Further, this study contributes to the TOE framework by addressing government regulations, audit bodies’ support and audit task complexity as environmental factors affecting CAATTs adoption in the context of the public sector.

Findings

The results revealed that for technological factors, only the compatibility affects CAATTs adoption by the IA departments. For organizational factors, organizational readiness, top management support, auditors’ information technology competency and entity size were found to be significant factors. From the environmental factors, both government regulation and audit task complexity influence the CAATTs adoption. Besides, entity size moderates the influence of top management support on the CAATTs adoption in the public sector.

Practical implications

The findings could highlight the significance of the CAATTs adoption in the public sector institutions (by internal auditors) post-COVID-19, taking into consideration the TOE framework’s factors. Also, the findings are significant for the decision-makers and regulators in declaring new legislation for the electronic IA profession in the Jordanian public sector.

Social implications

It turns out that the CAATTs adoption in the public sector can definitely enhance their ability to achieve the role of IA in preserving public funds and restricting corrupt practices within the public sector.

Originality/value

To the best of the authors’ knowledge, this study is one of the first studies that address the professional audit agency support and audit task complexity as environmental factors, as well as the entity size as an organizational factor, that affect CAATTs adoption in the IA department of the public sector.

Misunderstanding and Sensemaking Among Juvenile Probation Officers Working with Evidence-Based Practices

Evidence-based practices and programs (EBPs) have been adopted in juvenile probation agencies nationwide to maximize the number of successful probation cases. However, various pragmatic studies have found that JPOs are not yielding the expected benefits when compared to efficacy studies (Lipsey et al., 2010; Taxman & Belenko, 2011). Using focus group and survey data, the current study sought to increase our understanding of the gap between pragmatic and efficacy studies in juvenile probation settings by examining JPOs' perceptions and utilization of EBPs. The findings suggest that JPOs are misunderstanding how to use EBPs in daily practice, leaving them with negative perceptions of EBPs. Implications for improving JPO understanding and use of EBPs are discussed.

The Missing Link(age): Multilevel Contributors to Service Uptake Failure Among Youths on Community Justice Supervision

OBJECTIVES

Youths in the juvenile justice system often do not access needed behavioral health services. The behavioral health services cascade model was used to examine rates of substance use screening, identification of substance use treatment needs, and referral to and initiation of treatment among youths undergoing juvenile justice system intake and to identify when treatment access is most challenged. Characteristics associated with identification of behavioral health needs and linkage to community services were also examined.

METHODS

Data were drawn from administrative records of 33 community justice agencies in seven states participating in Juvenile Justice-Translational Research on Interventions for Adolescents in the Legal System, funded by the National Institute on Drug Abuse (N=8,307 youths). Contributions of youth, staff, agency, and county characteristics to identification of behavioral health needs and linkage to community services were examined.

RESULTS

More than 70% (5,942 of 8,307) of youths were screened for substance use problems, and more than half needed treatment. Among those in need, only about one-fifth were referred to treatment, and among those referred, 67.5% initiated treatment. Overall, <10% of youths with identified needs initiated services. Multivariable multilevel regression analyses revealed several contributors to service-related outcomes, with youths' level of supervision being among the strongest predictors of treatment referral.

CONCLUSIONS

Community justice agencies appear to follow an approach that focuses identification and linkage practices on concerns other than youths' behavioral health needs, although such needs contribute to reoffending. Local agencies should coordinate efforts to support interagency communication in the referral and cross-system linkage process.

Shifting probation culture and advancing juvenile probation reform through a community-based, participatory action research-informed training

Many jurisdictions are currently transforming their juvenile probation systems to reflect research-informed, developmentally based case management approaches. Training, developed through a community-based, participatory action research (CBPAR) framework and guided by a community-academic partnership, may promote probation staff's readiness for such change. This paper examined whether such training could serve as an effective method to impact organizational culture by exploring shifts in probation staff's knowledge, attitudes, and beliefs about graduated response - a structured juvenile probation case management system that aligns with research on adolescent development and youth behavior change. Data came from 559 juvenile probation staff trained in graduated response theory and practice between 2016 and 2019. Results demonstrated that at the end of a 1-day, CBPAR-grounded training program, participating staff reported significantly more buy-in to graduated response, greater knowledge of this new system, and attitudes more strongly in favor of graduated response and intended behaviors. Study findings revealed important shifts indicative of readiness for change within juvenile probation departments. Additional implementation strategies are needed to extend training gains and overcome organizational- and system-level barriers to change.

A Systematic Review of Organizational and Workforce Interventions to Improve the Culture and Climate of Youth-Service Settings

Both organizational culture and climate are associated with service quality and outcomes across youth-service settings. Increasing evidence indicates capacity of organizational interventions to promote a positive and effective culture and climate. Less is known about common intervention components across studies and service settings. The current systematic review reviewed 9223 citations and identified 31 studies, across six youth-service settings, measuring changes over time in organizational culture and climate following implementation of an organizational or workforce support intervention. Results highlight the promise of organizational interventions, a need for more comparison and randomized designs, and future directions for maximizing capacity of organizations to promote health for frontline providers and the children they serve.

Big data analytics adoption model for small and medium enterprises

Purpose

Big data analytics (BDA) is recognized as a turning point for firms to improve their performance. Although small- and medium-sized enterprises (SMEs) are crucial for every economy, they are lagging far behind in the usage of BDA. This study aims to provide a single and unified model for the adoption of BDA among SMEs with the integration of the technology–organization–environment (TOE) model and resource-based view.

Design/methodology/approach

A survey of 112 manufacturing SMEs in Iran was conducted, and the data were analysed using structural equation modelling to test the model of this study.

Findings

The results offer evidence of a BDA mediation effect in the relationship between technological, organizational and environmental contexts, and SMEs performance. The findings also demonstrated that technological and organizational elements are the more significant determinants of BDA adoption in the context of SMEs. In addition, the result of this study confirmed that BDA adoption could enhance the financial and market performance of SMEs.

Practical implications

Providing a single unified framework of BDA adoption for SMEs enables them to appreciate the importance of most influential elements (technology, organization and environment) in the adoption of BDA. Also, this study may encourage SMEs to be more willing to use BDA in their businesses.

Originality/value

Although there are studies on BDA adoption and firm performance among large companies, there is a lack of empirical research on SMEs, in particular, based on the TOE model. SMEs differ from large companies in terms of the availability of resources and size. Therefore, this study aimed to initiate a conceptual framework of BDA adoption for SMEs to assist them to be able to take advantage of the adoption of such technology.

Burnout and Mental Health Stigma Among Juvenile Probation Officers: The Moderating Effect of Participatory Atmosphere

Despite high rates of mental health problems among juvenile justice-involved youth, mental health stigma among juvenile probation officers (JPOs) is under-studied. This cross-sectional study examined effects of job burnout and workplace participatory atmosphere on mental health stigma among JPOs across Indiana (n = 226). Participatory atmosphere moderated the relationship between JPO burnout-related cynicism and mental health stigma (interaction β = - 0.14, p = .04); burnout was related to greater mental health stigma at low levels of participatory atmosphere. Findings suggest participatory atmosphere mitigates effects of burnout on mental health stigma among JPOs. Organizational-level interventions might help to reduce mental health stigma and combat negative effects from burnout among JPOs.

French cross-cultural adaptation of the Organizational Readiness for Implementing Change (ORIC)

BACKGROUND

Organizational readiness is a factor known to influence the predisposition of individuals within an organization to change. Based on Weiner's organizational theory, the "Organizational Readiness for Implementing Change" (ORIC) questionnaire was developed and validated to measure organizational readiness in healthcare contexts. However, no such tools allow French-speaking organizations to measure this concept. The objectives of this study were to (1) conduct a French cultural adaptation of the ORIC questionnaire, and (2) initiate the study of its psychometric properties.

METHODS

(1) Cross-cultural adaptation and translation processes were first conducted with the methodologies of Beaton, Vallerand and Massoubre. (2) Subsequently, internal consistency was documented by calculating Cronbach's alpha and inter-item and item-to-scale correlations. The study of construct validity was initiated with a confirmatory factor analysis.

RESULTS

A French 10-item scale named the Réceptivité organisationnelle à l'implantation d'un changement (ROIC) was developed and pretested by 125 occupational therapists working in Quebec homecare services. Cronbach's alpha values for the 2 item subscales show satisfactory internal consistency (Commitment: α = 0.84 and Efficacy: α = 0.86). Inter-item correlations revealed that the ROIC's items are moderately related to each other while item-to-total scale correlations pinpoint items that accounts for variance and influence internal consistency. Confirmatory factor analysis allowed the initiation of a substantial documentation of ROIC's model fit with the original version (CFI = 0.89, TLI = 0.85, SRMR = 0.08, and RMSEA = 0.12).

CONCLUSIONS

The ROIC is a new theory-based and translated questionnaire that can be used to rigorously document the organizational readiness of French organizations. The ROIC has the potential to support members of different organizations in the identification of subsequent efforts for the implementation of a change.

Assessing the Use and Impact of Points and Rewards across Four Federal Probation Districts: A Contingency Management Approach

Contingency management (CM) is a well-acknowledged behavioral approach for incentivizing changes in behavior and attitudes. A version of CM was piloted in four federal probation districts to determine whether systematically awarding points and rewards for key behaviors could be implemented and impact recidivism rates. A case controlled match design was conducted with a CM sample (referred to as Justice Steps (JSTEPS)) (n=128) who were individually matched to a comparison sample (n=128) on six variables related to recidivism. Analyses compared the number of technical violations and new arrests between JSTEPS participants and a historical comparison sample. Using Kaplan-Meier survival analysis, results indicate JSTEPS sites using early CM rewarding strategies tend have delayed recidivism than others. A research agenda is outlined.

Assessment of health provider readiness for telemedicine services in Uganda

BACKGROUND:

There are few telemedicine projects in Africa that have reached scale. One of the reasons proposed for this has been failure to assess health provider readiness for telemedicine prior to implementation.

OBJECTIVE:

To assess health provider readiness for implementation and integration of telemedicine services at three levels of Uganda's health facilities, namely, a national referral hospital (NRH), regional referral hospitals (RRHs) and level 4 health centres (HC-IVs) and to investigate factors associated with readiness for telemedicine.

METHOD:

A cross-sectional descriptive study was conducted at public healthcare facilities in Uganda. One RRH and HC-IV was identified from each of the Western, Eastern and Northern regions using a multistage random sampling technique. Mulago Hospital, which doubles as an RRH and HC-IV in the central region, was purposively identified for the study. After validation, a questionnaire was distributed for self-administration to senior administrators and doctors selected at the NRH, RRHs and HC-IVs. Data were analysed using bivariate associations between the outcome and the potential independent variables.

RESULTS:

In total, 114 healthcare workers completed the questionnaire. Of the respondents, 24 (21%) were from HC-IVs, 44 (39%) were from RRHs, and 46 (40%) from NRH. Doctors made up 45.8% (11) of respondents at HC-IVs, 59% (26) at RRHs, and 30.4% (14) at NRH. Administrators across all health facility levels were more likely to integrate telemedicine into the healthcare system than doctors (odd ratio = 1.39 [95% confidence interval = 0.38-4.95]). A significant association existed between the state of readiness and type of health facility, p < 0.001. The NRH and RRHs are more likely to integrate telemedicine into their systems than the HC-IVs. Among the factors investigated (job title, health facility, technology type, reason for referral and frequency of electronic communication), the level of health facility and title or role of healthcare worker were found to have a significant statistical association with being ready to integrate telemedicine into the healthcare system.

CONCLUSION:

Health provider readiness to integrate telemedicine services varies at the different levels of the health facility and job title or role. However, referral hospitals and administrators were more likely to integrate telemedicine than HC-IVs and doctors, respectively. While this study shows physicians and administrators are ready, other sectors (nurses, allied healthcare workers, public) will also need to be assessed.

The Juvenile Justice Behavioral Health Services Cascade: A new framework for measuring unmet substance use treatment services needs among adolescent offenders

OVERVIEW

Substance use and substance use disorders are highly prevalent among youth under juvenile justice (JJ) supervision, and related to delinquency, psychopathology, social problems, risky sex and sexually transmitted infections, and health problems. However, numerous gaps exist in the identification of behavioral health (BH) problems and in the subsequent referral, initiation and retention in treatment for youth in community justice settings. This reflects both organizational and systems factors, including coordination between justice and BH agencies.

METHODS AND RESULTS

This paper presents a new framework, the Juvenile Justice Behavioral Health Services Cascade ("Cascade"), for measuring unmet substance use treatment needs to illustrate how the cascade approach can be useful in understanding service delivery issues and identifying strategies to improve treatment engagement and outcomes for youth under community JJ supervision. We discuss the organizational and systems barriers for linking delinquent youth to BH services, and explain how the Cascade can help understand and address these barriers. We provide a detailed description of the sequential steps and measures of the Cascade, and then offer an example of its application from the Juvenile Justice - Translational Research on Interventions for Adolescents in the Legal System project (JJ-TRIALS), a multi-site research cooperative funded by the National Institute on Drug Abuse.

CONCLUSION

As illustrated with substance abuse treatment, the Cascade has potential for informing and guiding efforts to improve behavioral health service linkages for adolescent offenders, developing and testing interventions and policies to improve interagency and cross-systems coordination, and informing the development of measures and interventions for improving the implementation of treatment in complex multisystem service settings. Clinical Trials Registration number - NCT02672150.

Psychometric properties of implementation measures for public health and community settings and mapping of constructs against the Consolidated Framework for Implementation Research: a systematic review

BACKGROUND

Recent reviews have synthesised the psychometric properties of measures developed to examine implementation science constructs in healthcare and mental health settings. However, no reviews have focussed primarily on the properties of measures developed to assess innovations in public health and community settings. This review identified quantitative measures developed in public health and community settings, examined their psychometric properties, and described how the domains of each measure align with the five domains and 37 constructs of the Consolidated Framework for Implementation Research (CFIR).

METHODS

MEDLINE, PsycINFO, EMBASE, and CINAHL were searched to identify publications describing the development of measures to assess implementation science constructs in public health and community settings. The psychometric properties of each measure were assessed against recommended criteria for validity (face/content, construct, criterion), reliability (internal consistency, test-retest), responsiveness, acceptability, feasibility, and revalidation and cross-cultural adaptation. Relevant domains were mapped against implementation constructs defined by the CFIR.

RESULTS

Fifty-one measures met the inclusion criteria. The majority of these were developed in schools, universities, or colleges and other workplaces or organisations. Overall, most measures did not adequately assess or report psychometric properties. Forty-six percent of measures using exploratory factor analysis reported >50 % of variance was explained by the final model; none of the measures assessed using confirmatory factor analysis reported root mean square error of approximation (<0.06) or comparative fit index (>0.95). Fifty percent of measures reported Cronbach's alpha of <0.70 for at least one domain; 6 % adequately assessed test-retest reliability; 16 % of measures adequately assessed criterion validity (i.e. known-groups); 2 % adequately assessed convergent validity (r > 0.40). Twenty-five percent of measures reported revalidation or cross-cultural validation. The CFIR constructs most frequently assessed by the included measures were relative advantage, available resources, knowledge and beliefs, complexity, implementation climate, and other personal resources (assessed by more than ten measures). Five CFIR constructs were not addressed by any measure.

CONCLUSIONS

This review highlights gaps in the range of implementation constructs that are assessed by existing measures developed for use in public health and community settings. Moreover, measures with robust psychometric properties are lacking. Without rigorous tools, the factors associated with the successful implementation of innovations in these settings will remain unknown.